Mental Disorder
Conditions
Brief summary
The study's goal is to evaluate whether home treatment is an effective and efficient alternative to inpatient care for people with acute mental illness. Patients who meet the study's inclusion criteria are randomly assigned to either the condition home treatment or inpatient care (treatment-as-usual), during one year. Following two years, the two treatment modalities will be analyzed in terms of inpatient days, cost effectiveness, rehospitalization rate, severity of symptoms and sociodemographics.
Detailed description
The study's goal is to evaluate whether home treatment is an effective and efficient alternative to inpatient care for people with acute mental illness. Therefore, psychiatric patients in need of hospitalization who meet the study's inclusion criteria are randomly assigned to either the condition home treatment or inpatient care (treatment-as-usual) during one year. Home treatment patients are visited by a mobile and multiprofessional care team at their homes. Additionally, patients without a health insurance for home treatment and patients who are directly assigned to home treatment are included in separate study groups. Following two years, it will be checked whether home treatment leads to a reduction of inpatient days as a primary outcome. Further outcomes such as cost effectiveness, rehospitalization rate, severity of symptoms and sociodemographics will be also analyzed.
Interventions
OTHERHome Treatment
Patients with acute mental illness in need of inpatient care are treated at their houses by a mobile and multiprofessional care team if their health condition permits.
OTHERTreatment-as-usual
Patients with acute mental illness in need of inpatient care are treated in a psychiatric clinic.
Sponsors
Psychiatric University Hospital, Zurich
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* Need for acute psychiatric inpatient care * Residence in Zurich city * Health insurance for Home Treatment
Exclusion criteria
* none
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Inpatient days | 2 years follow-up | Number of inpatient days per patient |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Treatment costs | 2 years follow-up | Calculated direct treatment costs |
| Rehospitalization rate | 2 years follow-up | Number of rehospitalizations per patient and duration until rehospitalization |
| Adverse events | 2 years follow-up | e.g. suicide or attempted suicide |
| Total days in treatment | 2 years follow-up | Total days in Treatment per patient = inpatient and home treatment |
| Health of the Nation Outcome Scale (HoNOS) | 2 years follow-up | Scale measures the severity of symptoms and ranges from 0 to 48 (higher values mean worse outcome). |
| Clinical Global Impression Scale (CGI) | 2 years follow-up | Scale measures the severity of symptoms, global improvement and therapeutic response and ranges from 0 to 7 (higher values mean worse outcome). |
| Patients' satisfaction | 2 years follow-up | Patients' satisfaction assessed by the official questionnaire of the national association of the quality development in hospitals (ANQ) |
| Global Assessment of Functioning Scale (GAF) | 2 years follow-up | Scale measures social, occupational and psychological functioning and ranges from 0 to 100 (higher values mean better outcome). |
Countries
Switzerland
Contacts
Primary ContactMatthias Jäger, MD
Backup ContactSonja Mötteli, PhD
Outcome results
None listed