Cost-effectiveness of the implementation of a transitional discharge model for community integration of psychiatric clients: Practice insights and policy implications

摘要

Transitions in care are vulnerable periods for individuals with mental health illness. A network of therapeutic relationships during transitional period assists in discharge planning and recovery. This study evaluated the cost-effectiveness of the implementation of the transitional discharge model (TDM), an intervention for community integration of clients with mental health illness. This study used a participatory action research design to evaluate TDM implementation in nine hospitals across Ontario, Canada. The study enrolled 370 participants from participating hospitals. The analyses compared data on readmissions, length of stay, and hospitals spending that were collected at three points in time: prior and after four and eight months of TDM implementation. Corresponding results indicated no statistically significant differences in pre and post-intervention readmission means. The average length of stay, in eight months following the implementation, decreased by 9.8 days; however, results showed no statistically significant difference between pre and post-intervention median length of stay (mean rank = 6.63 vs. 5.64), Z = -0.585, p = 0.592). Additionally, comparisons of implementation cost to hospital spending found a total savings of $3,392,810. In addition to cost-savings to the health care system as demonstrated by reduced length of stay, TDM implementation provides cost-effective supports to help keep clients in the community and out of the hospital. As such, TDM implementation provides mental health practice and policy one of the unique opportunities for effective discharge of clients from hospital to community mental health services, through early discharge planning and connecting clients to community peer support system.