Evidence map›Paper›PMID 30419894›Full record

Trial reportBMC psychiatry2018

Health care utilization and cost after discharge from a mental health hospital; an RCT comparing community residential aftercare and treatment as usual.

Eirik Roos, Ottar Bjerkeset, Aslak Steinsbekk

Registry-linked trialAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMC psychiatry, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01719354 (Aftercare in the Community Health Center - a Venue for Identifying and Coordinating Community Services), which is not on this map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01719354 nacompletednot on this map

Aftercare in the Community Health Center - a Venue for Identifying and Coordinating Community Services

TypeinterventionalSponsorNorwegian University of Science and TechnologyRan2013 to 2015Enrolled41ConditionsMental DisordersArmsCommunity Health center, Control
3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Trial
  2. Article
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Eirik RoosDepartment of Public Health and Nursing, Norwegian University of Science and Technology, 7491, Trondheim, Norway. eirik.roos@trondheim.kommune.no.ORCID 0000-0002-1161-0125
Ottar BjerkesetFaculty of Nursing and Health Sciences, Nord University, Levanger, Norway.
Aslak SteinsbekkDepartment of Public Health and Nursing, Norwegian University of Science and Technology, 7491, Trondheim, Norway.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCommunity residential aftercare (step-down) services can ease the transition after a mental health hospital stay for patients with severe mental illness (SMI).

aimsTo investigate use of community and specialised mental health care services and costs in patients with SMI the first 12 months after discharge from a mental health hospital (MHH), comparing community residential aftercare (CRA) and treatment as usual.

methodsAn open parallel group randomised controlled trial with 41 participants. Data on use of specialist services (hospital, ambulant treatment and outpatient treatment) and community services (residential stays, home help, home care nursing, mental health consultation) were collected from specialist and community registers and health records.

resultsFor the primary outcome, utilisation of community mental health services, the intervention group used, on average, 29% fewer hours (mean differences - 21.6 h, 95% CI -93.1 to 44.9, p = .096) with a cost saving of 29% (mean differences - 1845 EUR, 95% CI -8267 to 4171, p = .102), but the estimates were imprecise. For the secondary outcome, the study groups had the same total number of inpatient days (66 days), but the intervention group had on average of 13.4 fewer inpatient days in the mental health hospital (95% CI -29.9 to 0.9. p = .008). The number of inpatient admissions (mean difference - 0.9 admissions, 95% CI -3.5 to 1.5, p = .224) and readmissions (- 0.8, 95% CI -2.5 to 0.9. p = .440) was lower in the intervention group. The intervention group had on average a total cost saving of 38.5% (mean differences - 23,071 EUR, 95% CI -45,450 to 3027. p = .057). A post hoc multivariable regression analysis controlling for baseline characteristics gave a reduction in total cost in favour of the intervention group of - 19,781 EUR (95% CI -44,072 to 4509, p=,107).

conclusionIn this study, it was not possible to draw a definite conclusion about the effect, due to the small sample and imprecision of the estimates. The direction of the results and size of the point estimate, in addition to findings in other studies, indicates that transferring patients ready for discharge from mental hospital to community residential aftercare can have the potential to reduce total consumption of health services and costs without increased hospital admissions.

trial registrationRegistered in clinicaltrials.gov ( NCT01719354 ).

Indexed as

AdultAftercareCommunity Mental Health ServicesCost SavingsFacilities and Services UtilizationFemaleHospitalizationHospitals, PsychiatricHumansLength of StayMaleMental DisordersPatient Acceptance of Health CarePatient DischargeResidential FacilitiesSurveys and QuestionnairesCommunity residential aftercareDischarge-ready mental health patientsSevere mental illnessStep-down

Identifiers

PMID30419894
PMCPMC6233284

What OpenQuestion holds

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LicenceCC BY
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.