Eur Child Adolesc Psychiatry. 2009;.
Publicly available costs data for child and adolescent psychiatric inpatient services
do not allow links to be made with patients' needs and outcomes. Without this information
commissioners may reduce the role of inpatient services on the basis of budgetary
impacts alone. This study estimates the support costs before, during and after an
inpatient admission and explores the associations between costs, needs and outcomes.
A detailed prospective cohort study of eight child and adolescent units was undertaken
in which participants were assessed at referral, admission, decision to discharge
and 1 year later. Mean admission costs were pound24,120, although the range was wide.
Associations were found between costs and patients' global impairment, age and exclusion
status. Support costs after admission were similar to pre-admission costs, but there
was some evidence to suggest that services were better targeted. Moves in England
to develop national tariffs for inpatient psychiatric episodes should be based on
the likely cost of the episode of treatment rather than costs per day, and good commissioning
requires more information on the predictors of such costs.