This study is a randomized trial comparing the clinical outcomes and cost-effectiveness of traditional inpatient psychiatric care with Short-Term Acute Residential Treatment (START), a patient-centered, community-based treatment model. Subjects are veterans at the VA San Diego Healthcare System with affective or psychotic disorders, who are in need of voluntary psychiatric hospitalization. Consenting subjects are randomly assigned to either the VA inpatient unit or START. At admission, discharge, and follow-up intervals of 2, 6, and 12 months, subjects are assessed on multiple measures, including the PANSS, SF-36 for Veterans, Quality of Well-Being, Addiction Severity Index, Perceptions of Care, and Ward Atmosphere Scale. These data are supplemented by qualitative methods, including semi-structured interviews, designed to explore patients’ perceptions. Currently, there are 58 subjects enrolled in the study; baseline and short-term follow-up data on 100-125 subjects and longer-term follow-up data on 75 or more will be available for presentation. Preliminary data on 42 subjects found no significant differences in clinical outcomes between START and hospital subjects, but START subjects rated their treatment environment more favorably (p between .015 and .001 on 4 Ward Atmosphere Scale subscales). In addition, fewer START subjects were homeless at the time of discharge than hospital subjects. If preliminary findings are upheld, results will support the greater cost-effectiveness of an alternative model of acute inpatient treatment. This study is also, to our knowledge, the first application of the Picker Institute’s concepts of patient-centered values in hospital care to research in mental health.
Learning Objectives: N/A
Keywords: Mental Health Care, Outcomes Research
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Community Research Foundation
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: employment (Executive Director)