A comprehensive costing analysis of intensive case management for individuals with severe mental illness and a history of homelessness, including cost-effectiveness as compared to standard care.

摘要

The current study used the comprehensive costing methodology of Knapp and Beecham (1990) to examine the comprehensive costs of community support services over the last six months (18--24 months) of a two-year study. The sample consisted of 77 clients with severe and persistent mental illness and a history of homelessness receiving either intensive case management (ICM) or standard care. Costs from the overall societal perspective were calculated by summing the direct and 'hidden' (e.g., travel time) costs associated with: (1) Agency costs (case management services), (2) governmental costs (e.g., non-agency health care costs, non-health care costs), and (3) family/friend costs. Subtracted from this initial total to reach a final societal cost were employment and/or volunteer 'benefits'. Of interest in the study was: (1) Examining the relationship between clients needs at 18 months of a two year trial, global societal costs per client for the six-month period from 18 to 24 months, and 24-month outcomes, and (2) cost-effectiveness of intensive case management over standard care from three costing perspectives (e.g., agency, government, society). Results yielded an overall average comprehensive cost of treatment (both ICM and standard care combined) per client of