Multifaceted impact evaluation of a day hospital compared to hospitalization on symptoms, social participation, service satisfaction and costs associated to service use

Abstract

Objective. This study compared clinical and functional changes, satisfaction with services and costs associated to service use, in participants treated in a day hospital for adults and seniors organized by diagnostic groups, with clients hospitalised. Methods. A quasi-experimental design was used. The experimental group was composed of clients (N = 40) treated in a day hospital. The comparison group included clinically and demographically similar clients hospitalised in the same institution (N = 13). Outcomes were symptoms, social participation, self-esteem, service satisfaction, utilization and associated costs. Results. During the index intervention, the level of improvement was significantly greater in the day hospital group regarding symptoms (P = 0.047), self-esteem (P = 0.01) and social participation (accomplishment: P = 0.02; satisfaction: P = 0.008). Following discharge, there was no significant difference in the level of change between the two groups on all variables. Day hospital participants were significantly more satisfied of several dimensions of services (P ≤ 0.01). Comparison of total mean costs of services used 6 months before and after index treatment showed a cost reduction of 38% in the day hospital group and 7% in the hospitalisation group. Conclusions. Day hospitals organized by diagnostic groups lead to positive clinical and economical outcomes over time.

Key Words::

• Psychiatric day hospital
• psychiatric hospitalisation
• outcomes
• client satisfaction
• mental health service use

Acknowledgements

The authors wish to thank the participants and the clinicians at Louis-H. Lafontaine Hospital, who graciously offered their time to collaborate to the study. Thank you to Mme Lise Trottier, statistician, for her help in data analysis. Finally, we are grateful to the Canadian Institutes of Health Research, Association des Hôpitaux de Jour en Psychiatrie du Québec, Quebec Network for Research on Aging, Centre de recherche Fernand-Seguin and the Canadian Occupational Therapy Foundation for their financial support.

Statement of Interest

There are no conflicts of interest for any of the authors.