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In-patient costs of agitation and containment in a mental health catchment area
dc.contributor.author | Serrano-Blanco, Antoni |
dc.contributor.author | Rubio-Valera, Maria |
dc.contributor.author | Aznar, Ignacio |
dc.contributor.author | Baladón, Luisa |
dc.contributor.author | Gibert, Karina |
dc.contributor.author | Gracia Canales, Alfredo |
dc.contributor.author | Kaskens, Lisette |
dc.contributor.author | Ortiz, José Miguel |
dc.contributor.author | Salvador Carulla, Luís |
dc.contributor.other | Universitat Politècnica de Catalunya. Departament d'Estadística i Investigació Operativa |
dc.date.accessioned | 2018-02-14T12:55:10Z |
dc.date.available | 2018-02-14T12:55:10Z |
dc.date.issued | 2017-06-06 |
dc.identifier.citation | Serrano-Blanco, A., Rubio-Valera, M., Aznar, I., Baladón, L., Gibert, Karina, Gracia, A., Kaskens, L., Ortiz, J., Salvador-Carulla, L. In-patient costs of agitation and containment in a mental health catchment area. "BMC psychiatry", 6 Juny 2017, vol. 17, núm. 1, p. 212-223. |
dc.identifier.issn | 1471-244X |
dc.identifier.uri | http://hdl.handle.net/2117/114120 |
dc.description.abstract | 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 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.extent | 12 p. |
dc.language.iso | eng |
dc.subject | Àrees temàtiques de la UPC::Matemàtiques i estadística::Probabilitat |
dc.subject | Àrees temàtiques de la UPC::Matemàtiques i estadística::Matemàtica discreta::Combinatòria |
dc.subject | Àrees temàtiques de la UPC::Matemàtiques i estadística::Estadística aplicada::Estadística biosanitària |
dc.subject.lcsh | Combinatorial analysis |
dc.subject.lcsh | Combinatorial probabilities |
dc.subject.lcsh | Biomathematics |
dc.subject.other | Aggression |
dc.subject.other | Agitation |
dc.subject.other | Containment |
dc.subject.other | Costs |
dc.subject.other | Health economics |
dc.subject.other | In-patient |
dc.subject.other | Mental health |
dc.subject.other | Restraint |
dc.subject.other | Seclusion |
dc.subject.other | Violence |
dc.title | In-patient costs of agitation and containment in a mental health catchment area |
dc.type | Article |
dc.subject.lemac | Combinatòria |
dc.subject.lemac | Probabilitats |
dc.subject.lemac | Biomatemàtica |
dc.contributor.group | Universitat Politècnica de Catalunya. KEMLG - Grup d'Enginyeria del Coneixement i Aprenentatge Automàtic |
dc.identifier.doi | 10.1186/s12888-017-1373-4 |
dc.description.peerreviewed | Peer Reviewed |
dc.subject.ams | Classificació AMS::05 Combinatorics::05E Algebraic combinatorics |
dc.subject.ams | Classificació AMS::60 Probability theory and stochastic processes::60C05 Combinatorial probability |
dc.subject.ams | Classificació AMS::92 Biology and other natural sciences::92B Mathematical biology in general |
dc.relation.publisherversion | https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-017-1373-4 |
dc.rights.access | Open Access |
local.identifier.drac | 21104612 |
dc.description.version | Postprint (published version) |
local.citation.author | Serrano-Blanco, A.; Rubio-Valera, M.; Aznar, I.; Baladón, L.; Gibert, Karina; Gracia, A.; Kaskens, L.; Ortiz, J.; Salvador-Carulla, L. |
local.citation.publicationName | BMC psychiatry |
local.citation.volume | 17 |
local.citation.number | 1 |
local.citation.startingPage | 212 |
local.citation.endingPage | 223 |
dc.identifier.pmid | 28583103 |
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