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Function assertive community treatment (FACT) and psychiatric service use in patients diagnosed with severe mental illness

Published online by Cambridge University Press:  21 April 2011

M. Drukker ,
J. Van Os ,
S. Sytema ,
G. Driessen ,
E. Visser  and
Ph. Delespaul
M. Drukker*
Affiliation:
Department of Psychiatry and Psychology, School for Mental Health and Neuroscience MHeNS, Maastricht University, The Netherlands
J. Van Os
Affiliation:
Department of Psychiatry and Psychology, School for Mental Health and Neuroscience MHeNS, Maastricht University, The Netherlands King's Health Partners Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK
S. Sytema
Affiliation:
Department of Psychiatry, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
G. Driessen
Affiliation:
Department of Psychiatry and Psychology, School for Mental Health and Neuroscience MHeNS, Maastricht University, The Netherlands
E. Visser
Affiliation:
Department of Psychiatry, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
Ph. Delespaul
Affiliation:
Department of Psychiatry and Psychology, School for Mental Health and Neuroscience MHeNS, Maastricht University, The Netherlands Integrated Care Division, Mondriaan, South-Limburg, The Netherlands
*
*Address for correspondence: Dr Marjan Drukker, Department of Psychiatry and Psychology, School for Mental Health and NeuroScience MHeNS, Maastricht University, P.O. Box 616, Vijverdal, 6200 MD Maastricht, The Netherlands. (Email: Marjan.Drukker@MaastrichtUniversity.nl)
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Abstract

Aim.

Previous work suggests that the Dutch variant of assertive community treatment (ACT), known as Function ACT (FACT), may be effective in increasing symptomatic remission rates when replacing a system of hospital-based care and separate community-based facilities. FACT guidelines propose a different pattern of psychiatric service consumption compared to traditional services, which should result in different costing parameters than care as usual (CAU).

Methods.

South-Limburg FACT patients, identified through the local psychiatric case register, were matched with patients from a non-FACT control region in the North of the Netherlands (NN). Matching was accomplished using propensity scoring including, among others, total and outpatient care consumption. Assessment, as an important ingredient of FACT, was the point of departure of the present analysis.

Results.

FACT patients, compared to CAU, had five more outpatient contacts after the index date. Cost-effectiveness was difficult to assess.

Conclusion.

Implementation of FACT results in measurable changes in mental health care use.

Keywords

Cost effectivenessHealth Services ResearchAssertive Community Treatmentschizophrenia and disorders with psychotic features
Type
Original Articles
Information
Epidemiology and Psychiatric Sciences , Volume 20 , Issue 3 , September 2011 , pp. 273 - 278
Copyright
Copyright © Cambridge University Press 2011

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