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

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

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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...[Show more]

dc.contributor.authorSerrano-Blanco, Antoni
dc.contributor.authorRubio-Valera, Maria
dc.contributor.authorAznar-Lou, Ignacio
dc.contributor.authorBaladón Higuera, Luisa
dc.contributor.authorGilbert, Karina
dc.contributor.authorGracia Canales, Alfredo
dc.contributor.authorKaskens, Lisette
dc.contributor.authorMiguel Ortiz, José
dc.contributor.authorSalvador-Carulla, Luis
dc.date.accessioned2020-12-20T20:57:02Z
dc.date.available2020-12-20T20:57:02Z
dc.identifier.issn1471-244X
dc.identifier.urihttp://hdl.handle.net/1885/218136
dc.description.abstractBackground 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.
dc.format.mimetypeapplication/pdf
dc.language.isoen_AU
dc.publisherBioMed Central
dc.sourceBMC Psychiatry
dc.titleIn-patient costs of agitation and containment in a mental health catchment area
dc.typeJournal article
local.description.notesImported from ARIES
local.identifier.citationvolume17
dc.date.issued2017
local.identifier.absfor111714 - Mental Health
local.identifier.ariespublicationa383154xPUB6764
local.type.statusPublished Version
local.contributor.affiliationSerrano-Blanco, Antoni , Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu
local.contributor.affiliationRubio-Valera, Maria, Universitat de Barcelona
local.contributor.affiliationAznar-Lou, Ignacio, Institut de Recerca Sant Joan de Déu
local.contributor.affiliationBaladón Higuera, Luisa, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona
local.contributor.affiliationGilbert, Karina, Universitat Politècnica de Catalunya-Barcelona Tech
local.contributor.affiliationGracia Canales, Alfredo, Área científica, Ferrer
local.contributor.affiliationKaskens, Lisette, Área científica, Ferrer
local.contributor.affiliationMiguel Ortiz, José , Parc Sanitari Sant Joan de Déu, Universitat de Barcelona
local.contributor.affiliationSalvador-Carulla, Luis, College of Health and Medicine, ANU
local.bibliographicCitation.issue1
local.identifier.doi10.1186/s12888-017-1373-4
dc.date.updated2020-11-23T10:41:20Z
local.identifier.scopusID2-s2.0-85020287077
local.identifier.thomsonID000405811500002
CollectionsANU Research Publications

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