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The effectiveness of psychiatric partial hospitalization and day care

Schene, Aart H.

Current Opinion in Psychiatry: July 2004 - Volume 17 - Issue 4 - p 303-309
doi: 10.1097/01.yco.0000133834.49790.9d
Services research and outcomes

Purpose of review The aim of this article is to review recent literature on partial hospitalization and day care in order to answer the following questions: (1) For what percentage of patients otherwise hospitalized is partial hospitalization a good alternative? (2) What is the (cost)-effectiveness of partial hospitalization in comparison with full hospitalization? (3) What is the (cost)-effectiveness of partial hospitalization in comparison with outpatient treatment and day care?

Recent findings Partial hospitalization is a good alternative for about one third of patients in need of full hospitalization. There seem to be no disadvantages regarding recovery (symptoms and social functioning), readmissions, suicide risk and unemployment at follow-up, while symptom reduction might be even more rapid in partial hospitalization. Families are no more burdened, while patients are more satisfied with services. Costs might be lower. It is far less clear what partial hospitalization has to offer patients who have no acute psychiatric illness but for whom their more severe psychopathology nevertheless does not respond to regular outpatient treatment.

Summary In current mental health care services partial hospitalization needs a more dominant position as an alternative for full hospitalization. Partial hospitalization or day care as an alternative for outpatient treatment certainly needs more research. Here the main unresolved question is whether partial hospitalization or day care has cost-effective advantages over continued outpatient treatment.

Further research on partial hospitalization should be executed on more homogeneous diagnostic groups. Treatments of proven efficacy should be given by the same staff within the two different settings (partial hospitalization or day care and outpatient) in order to study their effectiveness.

Department of Psychiatry, Academic Medical Center/University of Amsterdam, Amsterdam, The Netherlands

Correspondence to Aart H. Schene, MD, PhD, Professor of Psychiatry, Department of Psychiatry (A3.254), Academic Medical Center/University of Amsterdam, PO Box 22700, 1100 DE, Amsterdam, The Netherlands Tel: +31 20 5662088; e-mail: a.h.schene@amc.uva.nl

© 2004 Lippincott Williams & Wilkins, Inc.