Computerised clinical benefit-cost audit of mental health care II: Time input, costs, patient satisfaction

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Abstract
Data from a computerised clinical audit of behavioural psychotherapy in anxiety disorders allowed analysis of therapist time input, speed of clinical im provement, and patient satisfaction. Different clinicians varied greatly in how much tim e they spent per patient per com pleted episode, how much their patients improved per hour of therapist time, and how satisfied their patients were with care. Patient satisfaction was not tied tightly to amount or speed of improvement. Compared to outpatients, inpatients were more severe to start with, needed more therapist tim e to treat, and improved less per therapist hour spent. Most inpatients, however, were treated by less selected and less highly trained nurses. The audit approach described can answer central questions about care delivery once data are gathered from enough patients and therapists to make firm generalisations possible.