Cost-effectiveness of critical time intervention to reduce homelessness among persons with mental illness
Cost-effectiveness of critical time intervention to reduce homelessness among persons with mental illness
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DOI：
10.1176/appi.ps.54.6.884
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发表时间：
2003-06-01
影响因子：
3.8
通讯作者：
Wyatt, RJ
中科院分区：
文献类型：
--
作者：
Jones, K;Colson, PW;Wyatt, RJ
目的：需要制定具有成本效益的方案，帮助患有严重精神疾病的无家可归者从收容所过渡到社区生活。作者调查了关键时间干预计划的成本效益，这是一种有时间限制的强化病例管理适应方案，已被证明可以显着减少患有严重精神疾病的男性的复发性无家可归。研究方法：从1991年至1993年在男性公共庇护所的精神病项目招募的96名研究参与者被随机分配到关键时间干预计划或常规服务。两组的成本和住房结果进行了检查超过IS个月。结果如下：在研究期间，关键时间干预组和常规服务组的平均成本分别为52，374美元和51，649美元，用于急性护理服务，门诊服务，住房和庇护服务，刑事司法服务和转移收入。在同一时期，关键时间干预组经历的无家可归的夜晚明显少于普通护理组（32个夜晚对90个夜晚）。对于每一个愿意支付的价值-社会愿意为一个额外的非无家可归的夜晚花费的额外价格-大于152美元，关键时间干预组表现出显着更大的净住房稳定性的好处，表明成本效益，与通常的护理相比。结论：虽然很难进行，社区心理健康计划的成本效益研究可以为政策制定者和计划规划者提供丰富的信息。关键时刻干预方案不仅是减少严重精神疾病患者经常无家可归的有效方法，而且是一种具有成本效益的替代方案。
Objectives: Cost-effective programs are needed to assist homeless persons with severe mental illness in their transition from shelters to community living. The authors investigated the cost-effectiveness of the critical time intervention program, a time-limited adaptation of intensive case management, which has been shown to significantly reduce recurrent homelessness among men with severe mental illness. Methods: Ninety-six study participants recruited from a psychiatric program in a men's public shelter from 1991 to 1993 were randomly assigned to the critical time intervention program or to usual services. Costs and housing outcomes for the two groups were examined over IS months. Results: Over the study period, the critical time intervention group and the usual services group incurred mean costs of $52,374 and $51,649, respectively, for acute care services, outpatient services, housing and shelter services, criminal justice services, and transfer income. During the same period, the critical time intervention group experienced significantly fewer homeless nights than the usual care group (32 nights versus 90 nights). For each willingness-to-pay value-the additional price society is willing to spend for an additional nonhomeless night-greater than $152, the critical time intervention group exhibited a significantly greater net housing stability benefit, indicating cost-effectiveness, compared with usual care. Conclusions: Although difficult to conduct, studies of the cost-effectiveness of community mental health programs can yield rich information for policy makers and program planners. The critical time intervention program is not only an effective method to reduce recurrent homelessness among persons with severe mental illness but also represents a cost-effective alternative to the status quo.