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Economic impact of crisis intervention in emergency psychiatry: a naturalistic study

Published online by Cambridge University Press:  16 April 2020

Cristian Damsa*
Affiliation:
Emergency and Crisis Intervention Unit, University of Geneva Psychiatric Center, Switzerland Psychiatric Department, Hospital Center of Luxembourg, 4 Barblé Street, 1210Luxembourg
Christopher Hummel
Affiliation:
Department of psychiatry; 1 Boston Medical Center Place, Dowling 7, Boston, MA02118, United States
Vedat Sar
Affiliation:
Department of psychiatry, University Istanbul Medical School, Istanbul, Turkey
Thierry Di Clemente
Affiliation:
Resident, Emergency Psychiatry, Hospital Center of Luxembourg
Susanne Maris
Affiliation:
Clinical psychologist, private practice, Geneva, Switzerland
Coralie Lazignac
Affiliation:
Emergency and Crisis Intervention Unit University of Geneva, Psychiatric Center, Switzerland
Odile Massarczyk
Affiliation:
Psychologist, psychoanalyst, Liège, Belgium
Charles Pull
Affiliation:
Professor of psychiatry, Hospital Center of Luxembourg Psychiatric Department, Hospital Center of Luxembourg, 4 Barblé Street, 1210Luxembourg
*
*Corresponding author: Service d’accueil, d’urgence et de liaison psychiatrique, hôpital cantonal universitaire de Genève, 24, rue Micheli-du-Crest, 1211 Genève, Switzerland. Tél.: +41 223 723 866, fax:+41 223 728 599. E-mail address:[email protected]. (C. Damsa).
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Abstract

Objective

This is a naturalistic study comparing the outcomes of all emergency psychiatric interventions in the Hospital Center of Luxemburg during two periods of six months each, before and after the introduction of a crisis intervention program. The aim of the study was to investigate the clinical and economic impact of crisis intervention on psychiatric emergency admissions.

Methods

All subjects admitted to the emergency psychiatric unit during the two study periods were considered for participation. Data were collected retrospectively and comparisons were made between patients before (September 1, 2001 to February 28, 2002) and after (September 1, 2002 to February 28, 2003) crisis intervention programs were established.

Results

A comparison between the two patient groups demonstrated a significant decrease in the rate of voluntary hospitalizations after crisis intervention, and a significant increase in the number of patients with subsequent outpatient consultations. The cost increase due to ambulatory follow-ups was widely compensated for by the cost decrease due to hospitalization avoidance.

Conclusion

These preliminary findings suggest that crisis intervention leads to a shift from hospitalization to outpatient psychotherapeutic management in emergency psychiatric services, which has a significant economic impact.

Type
Original article
Copyright
Copyright © Elsevier SAS 2005

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