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Brief admission by self-referral as an add-on to usual care for individuals with self-harm at risk of suicide: cost-effectiveness and 4-year health-economic consequences after a Swedish randomized controlled trial.
- Source :
-
Nordic journal of psychiatry [Nord J Psychiatry] 2024 Aug; Vol. 78 (6), pp. 497-506. Date of Electronic Publication: 2024 Jun 14. - Publication Year :
- 2024
-
Abstract
- Background: Brief Admission by self-referral (BA) is a crisis-management intervention standardized for individuals with self-harm at risk of suicide. We analyzed its health-economic consequences.<br />Materials and Methods: BA plus treatment as usual (TAU) was compared with TAU alone in a 12-month randomized controlled trial with 117 participants regarding costs for hospital admissions, coercive measures, emergency care and health outcomes (quality-adjusted life years; QALYs). Participants were followed from 12 months before baseline to up to five years after.<br />Results: Over one year BA was associated with a mean annual cost reduction of 4800 or incremental cost of 4600 euros, depending on bed occupancy assumption. Cost-savings were greatest for individuals with >180 admission days in the year before baseline. In terms of health outcomes BA was associated with a QALY gain of 0.078. Uncertainty analyses indicated a significant QALY gain and ambiguity in costs, resulting in BA either dominating TAU or costing 59 000 euros per gained QALY.<br />Conclusion: BA is likely to produce QALY gains for individuals living with self-harm and suicidality. Cost-effectiveness depends on targeting high-need individuals and comparable bed utilization between BA and other psychiatric admissions. Future research should elaborate the explanatory factors for individual variations in the usage and benefit of BA.
- Subjects :
- Humans
Male
Female
Sweden
Adult
Referral and Consultation economics
Referral and Consultation statistics & numerical data
Middle Aged
Suicide Prevention
Hospitalization economics
Suicide statistics & numerical data
Suicide economics
Self-Injurious Behavior economics
Self-Injurious Behavior therapy
Cost-Benefit Analysis
Quality-Adjusted Life Years
Crisis Intervention economics
Subjects
Details
- Language :
- English
- ISSN :
- 1502-4725
- Volume :
- 78
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Nordic journal of psychiatry
- Publication Type :
- Academic Journal
- Accession number :
- 38875018
- Full Text :
- https://doi.org/10.1080/08039488.2024.2366854