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Open Access 01-12-2017 | Research article

In-patient costs of agitation and containment in a mental health catchment area

Authors: Antoni Serrano-Blanco, Maria Rubio-Valera, Ignacio Aznar-Lou, Luisa Baladón Higuera, Karina Gibert, Alfredo Gracia Canales, Lisette Kaskens, José Miguel Ortiz, Luis Salvador-Carulla

Published in: BMC Psychiatry | Issue 1/2017

Abstract

Background

There is a scarce number of studies on the cost of agitation and containment interventions and their results are still inconclusive. We aimed to calculate the economic consequences of agitation events in an in-patient psychiatric facility providing care for an urban catchment area.

Methods

A mixed approach combining secondary analysis of clinical databases, surveys and expert knowledge was used to model the 2013 direct costs of agitation and containment events for adult inpatients with mental disorders in an area of 640,572 adult inhabitants in South Barcelona (Spain). To calculate costs, a seven-step methodology with novel definition of agitation was used along with a staff survey, a database of containment events, and data on aggressive incidents. A micro-costing analysis of specific containment interventions was used to estimate both prevalence and direct costs from the healthcare provider perspective, by means of a mixed approach with a probabilistic model evaluated on real data. Due to the complex interaction of the multivariate covariances, a sensitivity analysis was conducted to have empirical bounds of variability.

Results

During 2013, 918 patients were admitted to the Acute Inpatient Unit. Of these, 52.8% were men, with a mean age of 44.6 years (SD = 15.5), 74.4% were compulsory admissions, 40.1% were diagnosed with schizophrenia or non-affective psychosis, with a mean length of stay of 24.6 days (SD = 16.9). The annual estimate of total agitation events was 508. The cost of containment interventions ranges from 282€ at the lowest level of agitation to 822€ when verbal containment plus seclusion and restraint have to be used. The annual total cost of agitation was 280,535€, representing 6.87% of the total costs of acute hospitalisation in the local area.

Conclusions

Agitation events are frequent and costly. Strategies to reduce their number and severity should be implemented to reduce costs to the Health System and alleviate patient suffering.

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Title: In-patient costs of agitation and containment in a mental health catchment area
Authors: Antoni Serrano-Blanco
Maria Rubio-Valera
Ignacio Aznar-Lou
Luisa Baladón Higuera
Karina Gibert
Alfredo Gracia Canales
Lisette Kaskens
José Miguel Ortiz
Luis Salvador-Carulla
Publication date: 01-12-2017
Publisher: BioMed Central
Published in: BMC Psychiatry / Issue 1/2017
Electronic ISSN: 1471-244X
DOI: https://doi.org/10.1186/s12888-017-1373-4

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

In-patient costs of agitation and containment in a mental health catchment area

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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