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Review: day hospital is not more effective than inpatient care but is associated with modest cost savings in acute psychiatric disorders

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 QUESTION: In patients with acute psychiatric disorders, what is the effectiveness of day hospital compared with inpatient care?

Data sources

Studies were identified by searching the Cochrane Library (Issue 4, 2000), Medline (1966 to December 2000), CINAHL (1982 to December 2000), EMBASE/Excerpta Medica (1980 to December 2000), PsycLIT (1967 to December 2000), and bibliographies of relevant articles. Researchers were contacted to identify unpublished studies.

Study selection

Randomised controlled trials of acute psychiatric day hospital compared with standard inpatient care for patients with acute psychiatric disorders (all diagnoses) were selected. Studies were excluded if a majority of participants were <18 or >65 years of age, or if participants had substance abuse or organic brain disorder.

Data extraction

Data were collected on study quality, patients, feasibility of day hospital treatment, extent of hospital care, clinical and social outcomes, and costs of care.

Main results

9 trials (1568 patients) met the selection …

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  • Source of funding: NHS Health Technology Assessment.

  • For correspondence: Dr M Marshall, Department of Community Psychiatry, University of Manchester, Preston, UK. mmarshall{at}

  • Abstract also appears in Evidence-Based Nursing.