Pathways to (specialized) care: patient costs and contacts en route to a first-episode psychosis clinic
Article first published online: 7 OCT 2013
© 2013 Wiley Publishing Asia Pty Ltd
Early Intervention in Psychiatry
Volume 8, Issue 4, pages 375–381, November 2014
How to Cite
Cheung, D., Roper, L. and Purdon, S. E. (2014), Pathways to (specialized) care: patient costs and contacts en route to a first-episode psychosis clinic. Early Intervention in Psychiatry, 8: 375–381. doi: 10.1111/eip.12093
- Issue published online: 22 OCT 2014
- Article first published online: 7 OCT 2013
- Manuscript Accepted: 18 AUG 2013
- Manuscript Received: 30 MAR 2013
- Faculty of Medicine & Dentistry at the University of Alberta and Alberta Health Services
- duration of untreated psychosis;
- early-episode psychosis clinic;
- pathways to care
To estimate the public health costs of specific help-seeking pathways into an early intervention psychosis clinic.
The sequence of police, emergency and mental health contacts utilized by 50 patients up to 1 year prior to admission was characterized using chart reviews and structured interviews. Cost estimates for contacts were obtained from provincial health/public service cost reports.
A high-cost inpatient pathway and a low-cost outpatient pathway were identified, with the former exceeding the latter by a factor of 18.5 in cost. This discrepancy was attributable to both the high cost of inpatient services and the long duration of inpatient admissions, as well as more frequent inpatient use of high-cost urgent services (e.g. police, emergency services).
Given the substantial cost differential between inpatient and outpatient routes, additional clarification of modifiable factors that determine pathways to care could have significant implications to health service delivery costs for this population.