P0312 - Cost effectiveness analysis of day hospital and inpatient treatment in Poland

Abstract

Aims:

Analysis of effectiveness and costs of day hospital in relation to stationary treatment. Study constitutes part of project carried out within 5th EC Framework Program-EDEN.

Material:

Out of 1089 patients admitted to Psychiatric Hospital in Wrocław(PHW) 238 patients were randomly assigned to either day hospital(n=l15) or inpatient ward(n=123). Patients were interviewed at 6 time-points comprising hospitalization, 3 and 12 months after discharge. Psychopathological symptoms and QoL were expressed in BPRS subscales and MANSA. Costs of treatment were assessed from clients' perspective–according to CSRI questionnaire, from payer's perspective– the National Health Fund(NHF) databases and from economic reports of PHW.

Results:

Day hospital was superior in alleviating negative symptoms, depression and anxiety. No statistical differences in effectiveness 3 months after discharge were found. One year after discharge higher level of psychopathology was reported amongst inpatient group and day-care group had higher number of rehospitalizations.

Costs were higher for NHF in day-care due to longer overall patients' hospitalization. However according to economic reports mean financial deficit of PHW generated by day patients was significantly lower. Comparison of length of hospitalization assessed with CSRI and NHF databases showed significant quantitative differences .

Conclusions:

Superiority of treatment effectiveness in inpatient ward over day-care was not confirmed using BPRS, MANSA and rehospitalization index. Simultaneously significantly lower mean financial deficit generated by day hospital due to lower indirect costs and underestimated NHF's rates for inpatients treatment showed superiority of day treatment in terms of CEA. Costs estimation based on clients' perspective may lead to significant misconception.