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Cost-effectiveness of community psychiatric nurse or out-patient psychiatrist care of neurotic patients

Published online by Cambridge University Press:  09 July 2009

S. P. Mangen*
Affiliation:
Department of Psychiatry, St George's Hospital Medical School, London, and the Economic Advisers Office, Department of Health and Social Security
E. S. Paykel*
Affiliation:
Department of Psychiatry, St George's Hospital Medical School, London, and the Economic Advisers Office, Department of Health and Social Security
J. H. Griffith
Affiliation:
Department of Psychiatry, St George's Hospital Medical School, London, and the Economic Advisers Office, Department of Health and Social Security
A. Burchell
Affiliation:
Department of Psychiatry, St George's Hospital Medical School, London, and the Economic Advisers Office, Department of Health and Social Security
P. Mancini
Affiliation:
Department of Psychiatry, St George's Hospital Medical School, London, and the Economic Advisers Office, Department of Health and Social Security
*
1Address for correspondence: Dr S. P. Mangen, 9 The Butts, Brentford, Middlesex TW8 8BJ.
2Address for reprints: Professor E. S. Paykel, Department of Psychiatry, St George's Hospital Medical School, Cranmer Terrace, London SW17 0RE.

Synopsis

In a prospective controlled investigation chronic patients, the majority with neurotic conditions, were randomly allocated either to community psychiatric nurses (CPN) as the main therapist or to routine out-patient psychiatrist follow-up. There was no statistically significant difference in the mean public expenditure for the two modes of care. The direct costs of psychiatric care comprised a small proportion of total public expenditure and were initially greater in the nursing group. Subsequently, and over the whole 18-month study period, nursing was the cheaper option in terms of these direct costs. Clinical and social outcomes were comparable in both follow-up groups. Consumer satisfaction was significantly greater among CPN patients. On balance, these results confirm the benefit of community psychiatric nursing for this patient group.

Type
Research Article
Copyright
Copyright © Cambridge University Press 1983

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References

REFERENCES

Chapman, J. R. (1979). Techniques of economic analysis in psychiatric practice. British Journal of Medical Psychology 52, 9197.CrossRefGoogle ScholarPubMed
Climent, C. E., de Arango, M. V., Plutchik, R. & Leon, C. A. (1978). Development of an alternative, efficient, low cost mental health delivery system in Cali, Colombia. I: The auxiliary nurse. Social Psychiatry 13, 2935.CrossRefGoogle Scholar
Drummond, M. F. (1980). Principles of Economic Appraisal in Health Care. Oxford University Press: London.Google Scholar
Gillis, L. & Egbert, S. (1973). The Psychiatric Outpatient: Clinical and Organisational Aspects. Faber & Faber: London.Google Scholar
Ginsberg, G. & Marks, I. M. (1977). Costs and benefits of behavioural psychotherapy: a pilot study of neurotics treated by nurse-therapists. Psychological Medicine 7, 685700.CrossRefGoogle ScholarPubMed
Glass, N. & Goldberg, D. (1977). Cost–benefit analysis and the evaluation of psychiatric services. Psychological Medicine 7, 701707.Google ScholarPubMed
Goldberg, D. & Jones, R. (1980). The costs and benefits of psychiatric care. In The Social Consequences of Psychiatric Illness (ed. Robins, L., Clayton, P. and Wing, J. K.), pp. 5570. Brunner/Mazel: New York.Google Scholar
Griffith, J. H. & Mangen, S. P. (1980). Community psychiatric nursing: a literature review. International Journal of Nursing Studies 17, 197210.CrossRefGoogle ScholarPubMed
Gunderson, J. & Mosher, L. (1975). The cost of schizophrenia. American Journal of Psychiatry 132, 901906.Google ScholarPubMed
Hunter, P. (1978). Schizophrenia and Community Psychiatric Nursing. National Schizophrenia Fellowship: Surbiton.Google Scholar
Le Grand, J. & Robinson, R. (1976). The Economics of Social Problems. Macmillan: London.CrossRefGoogle Scholar
Mangen, S. P. & Griffith, J. H. (1982 a). Patient satisfaction with community psychiatric nursing: a prospective controlled study. Journal of Advanced Nursing 7, 477482.CrossRefGoogle ScholarPubMed
Mangen, S. P. & Griffith, J. H. (1982 b). Community psychiatric nursing in Britain: the need for policy and planning. International Journal of Nursing Studies 19, 157166.CrossRefGoogle ScholarPubMed
Parnell, J. W. (1978). Community Psychiatric Nurses: A Descriptive Study. Queen's Nursing Institute: London.Google Scholar
Paykel, E. S., Mangen, S. P., Griffith, J. H. & Burns, T. P. (1982). Community psychiatric nursing for neurotic patients: a controlled study. British Journal of Psychiatry 140, 573581.CrossRefGoogle Scholar
Robinson, I. D. (1972). Description and evaluation of a psychiatric home visiting service. New Zealand Medical Journal 75, 1519.Google ScholarPubMed
Royal College of Psychiatrists, Social and Community Psychiatry Section Working Party (1980). Community Psychiatric Nursing: A Discussion Document. Bulletin of the Royal College of Psychiatrists August, 114118.Google Scholar
Sladden, S. (1979). Psychiatric Nursing in the Community: A Study of a Working Situation. Churchill Livingstone: Edinburgh.Google Scholar
Smith, S. L. (1972). Lowering the cost of psychiatric care. Canadian Psychiatric Association Journal 17, 423428.CrossRefGoogle ScholarPubMed
Taves, D. R. (1974). Minimization: a new method of assigning patients to treatment and control groups. Clinical and Pharmacological Therapy 15. 443453.CrossRefGoogle ScholarPubMed
Warren, J. (1971). Long acting phenothiazine injections given by psychiatric nurses in the community. Nursing Times 67, Occasional Papers, 4142.Google ScholarPubMed
Weisbrod, B. A., Test, M. A. & Stein, L. I. (1980). Alternative to mental hospital treatment. II: Economic benefit–cost analysis. Archives of General Psychiatry 37, 400405.CrossRefGoogle ScholarPubMed