{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T21:16:51Z","timestamp":1791062211893,"version":"4.1.0"},"reference-count":30,"publisher":"Royal College of Psychiatrists","issue":"6","license":[{"start":{"date-parts":[[2018,1,2]],"date-time":"2018-01-02T00:00:00Z","timestamp":1514851200000},"content-version":"unspecified","delay-in-days":6424,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br J Psychiatry"],"published-print":{"date-parts":[[2000,6]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Intensive case management is commonly advocated for the care of the severely mentally ill, but evidence of its cost-effectiveness is lacking.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To investigate the cost-effectiveness of intensive compared with standard case management for patients with severe psychosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>708 patients with psychosis and a history of repeated hospital admissions were randomly allocated to standard (case-loads 30\u201335) or intensive (case-loads 10\u201315) case management. Clinical and resource use data were assessed over two years.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>No statistically significant difference was found between intensive and standard case management in the total two-year costs of care per patient (means \u00a324 550 and \u00a322 700, respectively, difference \u00a31850, 95% Cl \u2013 \u00a31600 to \u00a35300). There was no evidence of differential effects in African\u2013Caribbean patients or in the most disabled. Psychiatric in-patient hospital stay accounted for 47% of the total costs, but neither such hospitalisation nor other clinical outcomes differed between the randomised groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Reduced case-loads have no clear beneficial effect on costs, clinical outcome or cost-effectiveness. The policy of advocating intensive case management for patients with severe psychosis is not supported by these results.<\/jats:p><\/jats:sec>","DOI":"10.1192\/bjp.176.6.537","type":"journal-article","created":{"date-parts":[[2002,8,29]],"date-time":"2002-08-29T17:36:18Z","timestamp":1030642578000},"page":"537-543","source":"Crossref","is-referenced-by-count":60,"title":["Cost-effectiveness of intensive <i>v.<\/i> standard case management for severe psychotic illness"],"prefix":"10.1192","volume":"176","author":[{"name":"UK700 Group","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Byford","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Fiander","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David 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