Cost-Effectiveness of Crisis Resolution Home Treatment for Managing Acute Psychiatric Crises in Southern Switzerland.

Objectives: This study aimed at providing the first formal cost-effectiveness evaluation of Crisis Resolution Home Treatment (CRHT) compared to hospitalization for the management of acute psychiatric crises in Switzerland.

Methods: Intervention (CRHT) and control (hospital) groups were formed based on patients' place of residence according to a quasi-experimental design. Patients were followed starting from an acute episode of care until 2 years after discharge. Effectiveness measures were variation of psychiatric symptoms between admission and discharge and number of non-readmission days. Direct costs were obtained from the Cantonal Psychiatric Clinic and patients' health insurance companies. Indirect costs were estimated based on sick leave certificates. Bootstrap resampling procedures and Cost-Effectiveness Acceptability Curves were used to assess cost differences between groups and cost-effectiveness.

Results: CRHT resulted generally less costly than hospitalization. In the treatment phase, cost-effectiveness depended on the type of psychiatric symptoms considered, while CRHT resulted highly cost-effective in the follow-up phase.

Conclusion: CRHT can be a cost-effective alternative to hospitalization for managing acute psychiatric crises in Ticino. Further research is needed to explore patients' conditions and characteristics associated with cost-effectiveness.