Is integrated care associated with service costs and admission rates to institutional settings? An observational study of community mental health teams for older people in England


Wilberforce, M; Tucker, S; Brand, C; Abendstern, M; Jasper, R; Challis, D; (2016) Is integrated care associated with service costs and admission rates to institutional settings? An observational study of community mental health teams for older people in England. International journal of geriatric psychiatry. ISSN 0885-6230 DOI: https://doi.org/10.1002/gps.4424

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Abstract

OBJECTIVES: To evaluate the association between the degree of integration in community mental health teams (CMHTs) and: (i) the costs of service provision; (ii) rates of mental health inpatient and care home admission.<br/> METHODS: An observational study of service use and admissions to institutional care was undertaken for a prospectively-sampled cohort of patients from eight CMHTs in England. Teams were chosen to represent 'high' or 'low' levels of integrated working practice and patients were followed-up for seven months. General linear models were used to estimate service costs and the likelihood of institutional admission.<br/> RESULTS: Patients supported by high integration teams received services costing an estimated 44% more than comparable patients in low integration teams. However, after controlling for case mix, no significant differences were found in the likelihood of admission to mental health inpatient wards or care homes between team types.<br/> CONCLUSIONS: Integrated mental health and social care teams appeared to facilitate greater access to community care services, but no consequent association was found with community tenure. Further research is required to identify the necessary and sufficient components of integrated community mental health care, and its effect on a wider range of outcomes using patient-reported measures. Copyright © 2015 John Wiley & Sons, Ltd.<br/>

Item Type: Article
Faculty and Department: Faculty of Public Health and Policy > Dept of Health Services Research and Policy
PubMed ID: 26833970
Web of Science ID: 387035200006
URI: http://researchonline.lshtm.ac.uk/id/eprint/2550559

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