Inpatient treatment in child and adolescent psychiatry – a prospective study of health gain and costs / Jonathan GREEN in Journal of Child Psychology and Psychiatry, 48-12 (December 2007)  

Public ISBD [article]  inJournal of Child Psychology and Psychiatry > 48-12 (December 2007) . - p.1259–1267 Titre : Inpatient treatment in child and adolescent psychiatry – a prospective study of health gain and costs Type de document : Texte imprimé et/ou numérique Auteurs : Jonathan GREEN, Auteur ; Jennifer BEECHAM, Auteur ; Brian JACOBS, Auteur ; Graham DUNN, Auteur ; Leo KROLL, Auteur ; Catherine TOBIAS, Auteur ; Jackie BRISKMAN, Auteur Année de publication : 2007 Article en page(s) : p.1259–1267 Langues : Anglais (eng) Mots-clés : Child adolescent psychiatry inpatient outcomes costs Index. décimale : PER Périodiques Résumé : Background: Inpatient treatment is a complex intervention for the most serious mental health disorders in child and adolescent psychiatry. This is the first large-scale study into its effectiveness and costs. Previous studies have been criticised for methodological weaknesses. Methods: A prospective cohort study, including economic evaluation, conducted in 8 UK units (total n = 150) with one year follow-up after discharge. Patients acted as their own controls. Outcome measurement was the clinician-rated Childhood Global Assessment Scale (CGAS); researcher-rated health needs assessment; parent- and teacher-rated symptomatology. Results: We found a significant (p < .001) and clinically meaningful 12-point improvement in CGAS following mean 16.6 week admission (effect size .92); this improvement was sustained at 1 year follow-up. Comparatively, during the mean 16.4 week pre-admission period there was a 3.7-point improvement (effect size .27). Health needs assessment showed similar gain (p < .001, effect size 1.25), as did teacher- and parent-rated symptoms. Improvement was found across all diagnoses. Longer stays, positive therapeutic alliance and better premorbid family functioning independently predicted better outcome. Mean cost of admission was £24,100; pre-admission and post-discharge support costs were similar. En ligne : http://dx.doi.org/10.1111/j.1469-7610.2007.01802.x Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=310 [article] Inpatient treatment in child and adolescent psychiatry – a prospective study of health gain and costs [Texte imprimé et/ou numérique] / Jonathan GREEN, Auteur ; Jennifer BEECHAM, Auteur ; Brian JACOBS, Auteur ; Graham DUNN, Auteur ; Leo KROLL, Auteur ; Catherine TOBIAS, Auteur ; Jackie BRISKMAN, Auteur . - 2007 . - p.1259–1267. Langues : Anglais (eng) in Journal of Child Psychology and Psychiatry > 48-12 (December 2007) . - p.1259–1267 Mots-clés : Child adolescent psychiatry inpatient outcomes costs Index. décimale : PER Périodiques Résumé : Background: Inpatient treatment is a complex intervention for the most serious mental health disorders in child and adolescent psychiatry. This is the first large-scale study into its effectiveness and costs. Previous studies have been criticised for methodological weaknesses. Methods: A prospective cohort study, including economic evaluation, conducted in 8 UK units (total n = 150) with one year follow-up after discharge. Patients acted as their own controls. Outcome measurement was the clinician-rated Childhood Global Assessment Scale (CGAS); researcher-rated health needs assessment; parent- and teacher-rated symptomatology. Results: We found a significant (p < .001) and clinically meaningful 12-point improvement in CGAS following mean 16.6 week admission (effect size .92); this improvement was sustained at 1 year follow-up. Comparatively, during the mean 16.4 week pre-admission period there was a 3.7-point improvement (effect size .27). Health needs assessment showed similar gain (p < .001, effect size 1.25), as did teacher- and parent-rated symptoms. Improvement was found across all diagnoses. Longer stays, positive therapeutic alliance and better premorbid family functioning independently predicted better outcome. Mean cost of admission was £24,100; pre-admission and post-discharge support costs were similar. En ligne : http://dx.doi.org/10.1111/j.1469-7610.2007.01802.x Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=310

The effect of inpatient care on measured Health Needs in children and adolescents / Brian JACOBS in Journal of Child Psychology and Psychiatry, 50-10 (October 2009)  

Public ISBD [article]  inJournal of Child Psychology and Psychiatry > 50-10 (October 2009) . - p.1273-1281 Titre : The effect of inpatient care on measured Health Needs in children and adolescents Type de document : Texte imprimé et/ou numérique Auteurs : Brian JACOBS, Auteur ; Jonathan GREEN, Auteur ; Graham DUNN, Auteur ; Catherine TOBIAS, Auteur ; Jacqueline A. BRISKMAN, Auteur ; Leopold KROLL, Auteur Année de publication : 2009 Article en page(s) : p.1273-1281 Langues : Anglais (eng) Mots-clés : Inpatient needs child adolescent outcome Index. décimale : PER Périodiques Résumé : Background: The concept of 'health need' relates patient problems in symptom and psychosocial domains to available appropriate treatments. We studied the effectiveness of inpatient treatment in modifying measured 'Health Needs' in children and adolescents admitted to UK inpatient units. Methods: A prospective cohort study of 150 children and adolescents admitted to eight UK inpatient units, using formal pre-admission, pre-discharge and 1-year follow-up measurement of Health Needs. Results: Total patient 'Cardinal Problems' reduced highly significantly (p < .001) from 8.5 at admission to 5.7 at discharge (effect size .81) and to 4.1 one year after discharge (effect size 1.35). Functional domains free of 'Health Needs' increased from 14.9 to 19.4 (effect size 1.08) from the point of admission to the end of follow-up. These changes were clinically meaningful, present in all domains and reduced morbidity to a level typical of outpatient cases. Conclusions: Admission (mean length 116 days, SD 88) leads to clinically important improvement in measured Health Needs over multiple domains for children with serious, complex mental health difficulties. These improvements in multiple symptom and functional domains persist over the next year. En ligne : http://dx.doi.org/10.1111/j.1469-7610.2009.02093.x Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=838 [article] The effect of inpatient care on measured Health Needs in children and adolescents [Texte imprimé et/ou numérique] / Brian JACOBS, Auteur ; Jonathan GREEN, Auteur ; Graham DUNN, Auteur ; Catherine TOBIAS, Auteur ; Jacqueline A. BRISKMAN, Auteur ; Leopold KROLL, Auteur . - 2009 . - p.1273-1281. Langues : Anglais (eng) in Journal of Child Psychology and Psychiatry > 50-10 (October 2009) . - p.1273-1281 Mots-clés : Inpatient needs child adolescent outcome Index. décimale : PER Périodiques Résumé : Background: The concept of 'health need' relates patient problems in symptom and psychosocial domains to available appropriate treatments. We studied the effectiveness of inpatient treatment in modifying measured 'Health Needs' in children and adolescents admitted to UK inpatient units. Methods: A prospective cohort study of 150 children and adolescents admitted to eight UK inpatient units, using formal pre-admission, pre-discharge and 1-year follow-up measurement of Health Needs. Results: Total patient 'Cardinal Problems' reduced highly significantly (p < .001) from 8.5 at admission to 5.7 at discharge (effect size .81) and to 4.1 one year after discharge (effect size 1.35). Functional domains free of 'Health Needs' increased from 14.9 to 19.4 (effect size 1.08) from the point of admission to the end of follow-up. These changes were clinically meaningful, present in all domains and reduced morbidity to a level typical of outpatient cases. Conclusions: Admission (mean length 116 days, SD 88) leads to clinically important improvement in measured Health Needs over multiple domains for children with serious, complex mental health difficulties. These improvements in multiple symptom and functional domains persist over the next year. En ligne : http://dx.doi.org/10.1111/j.1469-7610.2009.02093.x Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=838

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