Effectiveness of Case Management Program for Psychiatric Patients － The Experience in Syini Township of Nantou County

[[abstract]]Objective:Treatment interruption is the main reason for psychiatric diseases relapse and hospitalization. In the planning of Integrated Delivery System (IDS), the psychiatric hospital in this research began to provide continuous, integrative case management services to discharged psychiatric patients living at Xin-Yi Township of Nantou County. The study intended to evaluate the effectiveness of case management program of psychiatric patients. Methods:This study falls into a retrospective study. The research Hospital provided the information of 60 cases observed from August of Year 2003 till December of Year 2011, as the data resources. By employing paired-t test, the study designed to compare regular outpatient visits and re-hospitalization frequencies of the cases in short (i.e., Year 2003~Year 2005), middle (i.e., Year 2006~Year 2008), and long-term (i.e., Year 2009~Year 2011) period of time. In addition, by using independent-t test, we compare health-seeking behavior between drop out cases and keep participating cases. Result:The profile of 60 study cases are: average age of 40.98 years, mostly males (65%), 80% are junior high school educational level, 40% are single and married, respectively, mostly unemployed 41.7%, living with their families (100%), parents are their major caregivers (43.3%), mostly diagnosed as schizophrenia (65%), with age of 31-44 years as first on-set date (38.3%), history of psychiatric illness in less than 5 years as the majority (53.8%). In terms of effectiveness by paired t-test test, regular outpatient visits was 0.355 ± 0.242 times / month before the intervention, and 0.742 ± 0.280 times / month, 0.849 ± 0.208 times / month, and 0.905 ± 0.194 times / month, after the short term, middle-term, and long-term intervention, respectively (p value <0.01). The results indicated the longer involved in case management, the higher frequency of regular outpatient visits. In terms of re-hospitalization frequencies, there were 0.043± 0.096 times / year before the intervention, 0.012± 0.031 times / year, 0.024±0.032 times / year, and 0.012±0.037 times / year , after the short term, middle-term, and long-term intervention, in decreasing rate respectively. In addition, we found out the regular outpatient visits frequency of drop-out cases were lower than that of keep participating cases, especially for short term and long term cases (p value