This study aims to evaluate whether psychiatric home treatment is an effective and efficient alternative to acute inpatient care in mental hospitals. A one-year prevalence cohort of psychiatric patients in need of hospitalization are randomly assigned to either treatment at inpatient wards (treatment as usual) or a new care model with the additional option of treating patients at their homes by mobile care teams. The primary focus is on checking whether optional home treatment leads to a reduction of inpatient days during a two-year follow-up period. In addition, the two service models will be compared regarding treatment cost and outcomes as well as satisfaction of patients and their relatives with psychiatric care. Furthermore, a sub-cohort of randomly chosen patients from the prevalence-cohort will be examined by a highly trained clinical assessor to test and verify the diagnoses and the clinical ratings made by the staff members of the mental hospital under routine everyday conditions.
This study aims to evaluate whether psychiatric home treatment is an effective and efficient alternative to acute inpatient care in mental hospitals. A one-year prevalence cohort of psychiatric patients in need of hospitalization are randomly assigned to either treatment at inpatient wards (treatment as usual) or a new care model with the additional option of treating patients at their homes by mobile care teams. The primary focus is on checking whether optional home treatment for crisis intervention leads to a reduction of inpatient days during a two-year follow-up period. In addition, the two service models will be compared regarding treatment cost and outcomes as well as satisfaction of patients and their relatives with psychiatric care. Furthermore, a sub-cohort of randomly chosen patients from the prevalence-cohort will be examined by a highly trained clinical assessor to test and verify the diagnoses (SCID-I and SCID-II) and the clinical ratings (HoNOS) made by the staff members of the mental hospital under routine everyday conditions.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Enrollment
707
Patients are treated at home whenever possible and appropriate
Patients are treated at a mental hospital
Psychiatric Services Aargau AG
Brugg, Canton of Aargau, Switzerland
Number of inpatient days
Time frame: 2 years follow-up
Total days in treatment (inpatient + home treatment)
Time frame: 2 years follow-up
Direct treatment costs
Time frame: 2 years follow-up
Health of the Nation Outcome Scales (HoNOS)
Participants will be followed for the duration of hospital stay, an expected average of 4 weeks.
Time frame: Intake and discharge from treatment episode (expected average of 4 weeks)
Brief Symptom Checklist (BSCL)
Participants will be followed for the duration of hospital stay, an expected average of 4 weeks.
Time frame: Intake and discharge from treatment episode (expected average of 4 weeks)
Perceptions of Care-18
Participants will be assessed at discharge from hospital, after an expected average of 4 weeks.
Time frame: Discharge from treatment episode (expected average of 4 weeks)
Satisfaction of patients' relatives
Relatives' satisfaction will be assessed with an adapted version of the Perceptions of Care-18 questionnaire at discharge of the patients from hospital, after an expected average of 4 weeks. The proportion of satisfied relatives will be reported for both study arms.
Time frame: Discharge from treatment episode (expected average of 4 weeks)
Number of rehospitalizations per patient
Time frame: 2 years follow-up
Number of patients with adverse events
E.g. suicide or attempted suicide.
Time frame: 2 years follow-up
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