Admission intervention team: medical center based intensive case management of the seriously mentally ill.

The purpose of this study was to investigate the effect a medical center based intensive case management team had on utilization of inpatient psychiatric treatment. A frequent user of inpatient psychiatric hospitalization was defined as any patient who had 3 or more admissions during the 12 months prior to referral to the program. A within-subjects design was used comparing rates of hospital admissions and hospital days before and after program enrollment for 185 patients in the program for 1 year, and for 50 of those patients in the program for 7 years. Cost savings across program years 1992 through 2000 were calculated using inpatient per diem rates. The number of admissions, length of stay, and cost of care were significantly reduced during the study period. The results of this study clearly demonstrate that a medical center based intensive case management team can significantly reduce admissions, length of stay, and the cost of care of frequent users of hospital inpatient services. Development of a true multidisciplinary team, enhancement of medication and treatment compliance, and a team case management model were the factors suggested as contributing to the success of this treatment program.