Cost-Effectiveness of a Rapid Response Team Intervention for Suicidal Youth Presenting at an Emergency Department

• Published in: Canadian journal of psychiatry 2014-06, Vol.59 (6), p.310-318
• Main Authors: Latimer, Eric A, Gariépy, Geneviève, Greenfield, Brian
• Format: Article
• Language: English
• Subjects: Adolescent; Ambulatory Care - economics; Child; Cost-Benefit Analysis; Emergency Service, Hospital - economics; Female; Health Resources - economics; Health Resources - utilization; Hospital Costs - statistics & numerical data; Hospital Rapid Response Team - economics; Hospitalization; Hospitals; Hospitals, Pediatric - economics; Humans; Interview, Psychological; Male; Medical research; National Health Programs - economics; Original Research; Pregnancy; Psychiatry; Quebec; Studies; Suicide - economics; Suicide - prevention & control; Suicide - psychology; Suicide, Attempted - economics; Suicide, Attempted - prevention & control; Suicide, Attempted - psychology; Suicides & suicide attempts; Teenagers; Utilization Review
• ISSN: 0706-7437; 1497-0015
• DOI: 10.1177/070674371405900604

Objective: To investigate the cost-effectiveness of a rapid response team (RRT), compared with usual care (UC), for treating suicidal adolescents. Methods: Suicidal adolescents (n = 286) presenting at an emergency department were enrolled in a trial to compare UC with enhanced outpatient care provided by an RRT of health professionals. Functioning (Child Global Assessment Scale) and suicidality (Spectrum of Suicidal Behavior Scale) scores were measured at baseline and 6 months later. Resource use and cost data were collected from several sources during the same period. Results: As previously reported, there was no statistically or clinically significant difference in either functioning or suicidality between the groups. Costs of the RRT were lower by $1886, thus –$1886 (95% CI –$4238 to $466), from the perspective of the treating hospital, and by $991, thus –$991 (95% CI –$5580 to $3598), from the perspective of society. If decision makers are not willing to pay for any improvement in functioning or suicidality, the RRT has a 95% probability of being cost-effective from the perspective of the treating hospital. From the point of view of society, the probability of the intervention being cost-effective is about 70% for functioning and 63% for suicidality. The difference between the 2 perspectives is mainly attributable to the cost of hospitalizations outside the treating hospital. Conclusions: An RRT intervention appears to be cost-effective, compared with UC, from the point of view of the treating hospital, but there is no difference from the point of view of society.