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Evaluating sustainability : a retrospective cohort analysis of the Oxfordshire therapeutic community
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Maughan, Daniel, Lillywhite, Robert, Pearce, Steve, Pillinger, Toby and Weich, Scott (2016) Evaluating sustainability : a retrospective cohort analysis of the Oxfordshire therapeutic community. BMC Psychiatry, 16 (1). 285. doi:10.1186/s12888-016-0994-3 ISSN 1471-244X.
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Official URL: http://dx.doi.org/10.1186/s12888-016-0994-3
Abstract
Background:
Therapeutic communities (TCs) could reduce the health care use of people with personality disorder [1, 2] and in turn reduce the financial and environmental costs of services. Our hypothesis is that three years following entry to a TC service, patients have reduced subsequent health care use and associated reductions in financial costs and carbon footprint.
Methods:
A retrospective four-year cohort study examined changes in health care use following entry to the Oxfordshire TC service. Comparative analysis was undertaken on a treated (n=40) and a control group (referred but who declined treatment; n=45).
Financial costs and carbon footprint of health care use were calculated using national tariffs and standard carbon conversion factors. Mean changes in these outcomes were compared over 1, 2 and 3 years and adjusted for costs and carbon footprints in the year prior to joining the TC service.
Results:
Compared to baseline, the group receiving TC care had greater reductions in financial costs and carbon footprint associated with A&E attendances (p=0.04) and crisis mental health appointments (p=0.04) than the control group. There were significantly greater reductions in carbon footprint for all secondary health care use, both physical and mental health care, after three years (p=0.04) in the TC group.
Conclusions: TC services may have the potential to reduce the financial cost and carbon footprint of health care.
Item Type: | Journal Article | ||||||||||
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Alternative Title: | |||||||||||
Subjects: | R Medicine > RC Internal medicine | ||||||||||
Divisions: | Faculty of Science, Engineering and Medicine > Science > Life Sciences (2010- ) | ||||||||||
Library of Congress Subject Headings (LCSH): | Personality disorders -- Treatment -- Cost effectiveness -- Oxfordshire (England) | ||||||||||
Journal or Publication Title: | BMC Psychiatry | ||||||||||
Publisher: | BioMed Central Ltd. | ||||||||||
ISSN: | 1471-244X | ||||||||||
Official Date: | 2016 | ||||||||||
Dates: |
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Volume: | 16 | ||||||||||
Number: | 1 | ||||||||||
Article Number: | 285 | ||||||||||
DOI: | 10.1186/s12888-016-0994-3 | ||||||||||
Status: | Peer Reviewed | ||||||||||
Publication Status: | Published | ||||||||||
Access rights to Published version: | Open Access (Creative Commons) | ||||||||||
Date of first compliant deposit: | 22 July 2016 | ||||||||||
Date of first compliant Open Access: | 4 May 2017 | ||||||||||
Funder: | Royal College of Psychiatrists |
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