Utilization of Psychiatric Hospital Services Following Intensive Home Treatment
A Nonrandomized Clinical Trial
Importance: Home treatment (HT) has been linked to fewer days in the hospital but lacks proof of reducing overall psychiatric hospital service use (including inpatient treatment, home treatment, and day clinics).
Objective: This study aimed to compare intensive home treatment (IHT) with inpatient treatment (IT) regarding readmission rates, social outcomes, and clinical outcomes.
Design and Participants: Conducted from 2020 to 2022 in 10 psychiatric hospitals in Germany, this nonrandomized trial involved patients who met specific criteria. Propensity score matching was used for comparison at the 12-month follow-up with standardized tools and routine hospital data.
Intervention: IHT offered daily psychiatric treatment at home, while IT provided traditional inpatient care. The average treatment duration was 37.2 days for IHT and 28.2 days for IT.
Main Outcomes: The primary outcome was the inpatient readmission rate. Secondary outcomes included combined readmission rates, total inpatient days, job integration, quality of life, psychosocial functioning, symptom severity, and recovery.
Results: Out of 1396 individuals screened, 200 patients in each group were analyzed. At the 12-month follow-up, IHT patients had a lower readmission rate (31.12% vs. 49.74% for IT) and fewer inpatient days, indicating better outcomes (P < .001).
Conclusions: This trial suggests that IHT is a promising alternative to IT, with patients experiencing fewer hospital visits and days in care.
Clinical Trials Registration: ClinicalTrials.gov Identifier: NCT04745507.
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