Cost-effectiveness of Intensive Psychiatric Community Care for High Users of Inpatient Services

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Abstract
EXPERIMENTAL studies published during the past 15 years have reported that concentrating treatment resources in community-based assertive community treatment (ACT) teams or intensive case-management programs can result in improved clinical status of severely mentally ill patients at no additional cost.1-6 Some studies, however, have found case management to be associated with no clinical change and/or increased service utilization and cost.7-11 Three recent reviews12-14 concluded that intensive community treatment frequently reduces hospital use but does not always achieve net cost savings, and far less consistently achieves clinical improvement.