In a traditional cost-effectiveness analysis there is a single objective which is usually measured by a common physical unit (i.e. the number of breast cancers detected, number of chronic schizophrenics who return to full employment), and we want either to achieve a fixed level of objective at minimum cost, or as much objective as we can for a fixed cost. There is, therefore, some sort of outcome which is explicitly stated for each service or method of treatment, and the analysis will compare the cost of achieving the goal by various means. It is not easy to find examples of such analyses in psychiatry, since it is unusual to think of the effectiveness of treatment in such crude terms. Patients who have received a particular treatment cannot be usefully divided into ‘still ill’ and ’cured’; and indeed we may wish to examine the effects of a particular treatment on many different aspects of psychosocial adjustment. It is also sometimes necessary to evaluate services which do not reduce disability at all: for example, services for mentally handicapped children, or for severely demented old people. Fortunately, it is possible to modify cost-effectiveness analysis in such a way that useful conclusions about psychiatric services can still be drawn.
KeywordsCash Flow Treatment Service Psychiatric Service Psychiatric Care Social Adjustment
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- Goldberg, D. and Jones, R., 1980, The costs and benefits of psychiatric care, reprinted from: “The Social Consequences of Psychiatric Illness”, Robins, Clayton Wing, ed.,Publisher, Brunner/Mazel, Inc., New York, (1980)Google Scholar
- Jones, R., Goldberg, D. and Hughes, 1980, A comparison of two different services treating schizophrenia: a cost-benefit approach, Psychol. Med., 10: 493–505Google Scholar
- May, P.R.A., 1971, Cost-efficiency of treatments for the schizophrenic patient, Amer. J. Psychiat., 127: 10Google Scholar
- Williams, A., 1974, The Cost benefit approach, Br. Med. Bull. 3: 30 252–256Google Scholar
- Wing, J. and Wykes, J.,1982, Long-term community care: experience in a London Borough, Psychol. Med. Mono Suppl., 2: 59–97Google Scholar