Abstract
Background: The mental illness high risk to violence patients need to have a continuum well care. Since these patients have tendency of psychiatric relapse and mental health risks. Therefore, the continuity of care system in mental illness patients project was created to help and care for them. Objective: To compare the cost and effectiveness by using cost-effectiveness analysis between continuity of care system (home health care service every 1 month) in severe mental illness high risk to violence patients at primary care setting versus routine service system in provider perspective. Methods: Data was derived from randomized controlled trial study between 1 January, 2016, to 30 June, 2016. The patients who been diagnosed as F200 to F299 and had at least 1 or more criteria of severe mental illness high risk to violence were recruited to the research. Result: There were 72 patients for continuity of care system and 90 patients for routine service system. Patients in continuity of care system had higher re-hospitalize incident rate (7.04) than patients in routine service system (5.56) with no significant at p .750. The incremental cost for continuity of care system was 30,716 Baht. The risk factor in this patient were a discontinuous medicine, alcohol or substance abuse. Number needed to treat (NNT) of re-hospitalization was 13. There were no statistical difference of mean of global assessment scale , disease burden scale and psychological scale at the 6th.month between continuity of care system and routine service system. Conclusions: This study showed that the continuity of care system can’t reduce re- hospitalization rate in severe mental illness psychiatric patients. The incremental cost for the continuity of care system to re-hospitalization rate was 30,716 Bath.
