International differences in home treatment for mental health problems. Results of a systematic review

Br J Psychiatry. 2002 Nov:181:375-82. doi: 10.1192/bjp.181.5.375.

Abstract

Background: It is perceived that North American home treatment studies reveal greater success in reducing days in hospital than do European studies. There are difficulties in extrapolating findings internationally.

Aims: We aimed to determine whether North American studies find greater reductions in days in hospital and whether experimental service patients in North American studies spend less time in hospital.

Method: The results of a systematic review were analysed with respect to study location. Service components ascertained through follow-up were utilised to interpret the meta-analyses conducted.

Results: Most of the 91 studies found were from the USA and UK. North American studies found a difference of one hospital day (per patient per month) more than European studies but there was no difference in experimental data between the two locations.

Conclusions: North American studies demonstrate greater differences in days in hospital but patients in their experimental services seem to spend no fewer days in hospital, implying a disparity in control services.

Publication types

  • Comparative Study
  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Community Mental Health Services*
  • Follow-Up Studies
  • Home Care Services*
  • Hospitals, Psychiatric / statistics & numerical data*
  • Humans
  • Length of Stay / statistics & numerical data*
  • Mental Disorders / therapy*
  • United Kingdom
  • United States