Affordability of Forensic Assertive Community Treatment Programs: A Return-on-Investment Analysis.
Affordability of Forensic Assertive Community Treatment Programs: A Return-on-Investment Analysis.
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法医自信社区治疗计划的承受能力：投资回报分析。
DOI：
10.1176/appi.ps.20220186
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发表时间：
2023
期刊：
影响因子：
--
通讯作者：
Lamberti,JSteven
中科院分区：
文献类型：
--
作者：
Maeng,Daniel;Tsun,Zhi-Yang;Lesch,Eric;Jacobowitz,DavidB;Strawderman,RobertL;Harrington,DonaldK;Li,Yue;Weisman,RobertL;Lamberti,JSteven
在这项研究中，作者评估了投资回报率（ROI）与法医自信的社区治疗（FACT）programme.MethodsA回顾性二次数据分析的随机对照试验，包括70名法律参与的严重精神疾病患者进行了罗切斯特，纽约。患者被随机分配接受FACT或门诊精神病治疗，包括强化病例管理。从纽约州医疗补助和惩教部的记录中获得与精神病急诊科就诊、精神病住院天数和监禁天数相关的服务成本单位。基于每例患者每年（PPPY）计算的两个试验组之间的总美元价值差异构成了FACT干预的回报。FACT投资成本定义为相对于对照组，与FACT实施相关的总额外PPPY成本。投资回报率的计算方法是将投资回报除以投资成本。（以2019年美元计; 95%可信区间CI = 3，262 - 51，913），这主要是由于精神科住院日减少，估计投资成本为18，440 PPPY（95% CI= 15，215 - 21，665），意味着ROI为1.50（95%CI = 0.35-2.97）为FACT.结论罗切斯特FACT计划与约1.50回报每1花费在其实施，即使不考虑潜在的回报从其他来源，包括减少急性医疗护理，与犯罪有关的损失和公共安全成本。投资回报率估计高度依赖于特定的背景因素，特别是医疗补助报销率自信的社区治疗和住院时间。
ObjectiveIn this study, the authors assessed return on investment (ROI) associated with a forensic assertive community treatment (FACT) program.MethodsA retrospective secondary data analysis of a randomized controlled trial comprising 70 legal-involved patients with severe mental illness was conducted in Rochester, New York. Patients were randomly assigned to receive either FACT or outpatient psychiatric treatment including intensive case management. Unit of service costs associated with psychiatric emergency department visits, psychiatric inpatient days, and days in jail were obtained from records of New York State Medicaid and the Department of Corrections. The total dollar value difference between the two trial arms calculated on a per-patient-per-year (PPPY) basis constituted the return from the FACT intervention. The FACT investment cost was defined by the total additional PPPY cost associated with FACT implementation relative to the control group. ROI was calculated by dividing the return by the investment cost.ResultsThe estimated return from FACT was 27,588PPPY(in2019dollars;95%confidenceintervalCI= 3,262–51,913),whichwasdrivenlargelybyreductionsinpsychiatricinpatientdays,andtheestimatedinvestmentcostwas 18,440 PPPY (95% CI= 15,215– 21,665), implying an ROI of 1.50 (95% CI= 0.35–2.97) for FACT.ConclusionsThe Rochester FACT program was associated with approximately 1.50returnforevery 1 spent on its implementation, even without considering potential returns from other sources, including reductions in acute medical care, crime-related damages, and public safety costs. ROI estimates were highly dependent on context-specific factors, particularly Medicaid reimbursement rates for assertive community treatment and hospital stays.
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DOI：
10.1176/ps.2008.59.2.205
发表时间：
2008
期刊：
Psychiatric services (Washington, D.C.)
影响因子：
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作者：
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