TY - JOUR
KW - Activities of Daily Living/classification/psychology
KW - Adult
KW - Alberta
KW - Analysis of Variance
KW - Community Mental Health Services/economics
KW - Continuity of Patient Care/economics
KW - Cost Allocation
KW - Cost-Benefit Analysis
KW - Economics
KW - Female
KW - Health Care Costs/statistics & numerical data
KW - Health Services Needs and Demand
KW - Hospitalization/economics
KW - Humans
KW - Male
KW - Middle Aged
KW - Outcome Assessment (Health Care)/statistics & numerical data
KW - Psychotic Disorders/economics/rehabilitation
KW - Quality of Life/psychology
KW - Regression Analysis
AU - C. R. Mitton
AU - C. E. Adair
AU - G. M. McDougall
AU - G. Marcoux
A1 - 
AB - OBJECTIVES: Although the association between continuity of care and health outcomes among persons with severe mental illness is beginning to be elucidated, the association between continuity and costs has remained virtually unexplored. The purpose of this study was to examine the relationship of continuity of care and health care costs in a sample of 437 adults with severe mental illness in three health regions of Alberta, Canada. METHODS: Service use events and costs were tracked through self-reported and administrative data. Associations between continuity and costs were examined by using analysis of variance and regression analysis. RESULTS: Mean+/-SD total, hospital, and community cost over the 17-month study period were $24,070+/-$25,643, $12,505+/-$20,991, and $2,848+/-$4,420, respectively. The difference in means across levels of observer-rated continuity was not statistically significant for total cost, but improved continuity was associated with both lower hospital cost and higher community cost. Total cost was significantly lower for patients with a higher self-rated quality of life as indicated on the EQ-5D visual analogue scale, although associations did not hold up in the regression analysis. Patients with higher functioning as rated by the Multnomah Community Abilities Scale had significantly lower total and community costs. CONCLUSIONS: The study showed a relationship between continuity of care and both hospital and community costs. The data also indicate that a relationship exists between cost and level of patient functioning. It will be necessary to conduct further studies using experimental designs to examine the impact of shifting resources from hospitals to the community, particularly for high-need patients, on continuity of care and subsequent outcomes.
BT - Psychiatric services (Washington, D.C.)
C5 - Financing & Sustainability
CP - 9
CY - United States
DO - 10.1176/appi.ps.56.9.1070
IS - 9
JF - Psychiatric services (Washington, D.C.)
N2 - OBJECTIVES: Although the association between continuity of care and health outcomes among persons with severe mental illness is beginning to be elucidated, the association between continuity and costs has remained virtually unexplored. The purpose of this study was to examine the relationship of continuity of care and health care costs in a sample of 437 adults with severe mental illness in three health regions of Alberta, Canada. METHODS: Service use events and costs were tracked through self-reported and administrative data. Associations between continuity and costs were examined by using analysis of variance and regression analysis. RESULTS: Mean+/-SD total, hospital, and community cost over the 17-month study period were $24,070+/-$25,643, $12,505+/-$20,991, and $2,848+/-$4,420, respectively. The difference in means across levels of observer-rated continuity was not statistically significant for total cost, but improved continuity was associated with both lower hospital cost and higher community cost. Total cost was significantly lower for patients with a higher self-rated quality of life as indicated on the EQ-5D visual analogue scale, although associations did not hold up in the regression analysis. Patients with higher functioning as rated by the Multnomah Community Abilities Scale had significantly lower total and community costs. CONCLUSIONS: The study showed a relationship between continuity of care and both hospital and community costs. The data also indicate that a relationship exists between cost and level of patient functioning. It will be necessary to conduct further studies using experimental designs to examine the impact of shifting resources from hospitals to the community, particularly for high-need patients, on continuity of care and subsequent outcomes.
PP - United States
PY - 2005
SN - 1075-2730; 1075-2730
SP - 1070
EP - 1076
EP - 
T1 - Continuity of care and health care costs among persons with severe mental illness
T2 - Psychiatric services (Washington, D.C.)
TI - Continuity of care and health care costs among persons with severe mental illness
U1 - Financing & Sustainability
U2 - 16148319
U3 - 10.1176/appi.ps.56.9.1070
VL - 56
VO - 1075-2730; 1075-2730
Y1 - 2005
ER -