Citrine

Aim

To measure in detail the costs associated with an inpatient admission.

Background

A questionnaire for measuring the activity at inpatient psychiatric wards is being developed. Activities and contacts with staff members have an impact on both clinical outcomes and the cost of the care provided in inpatient psychiatric wards. The instrument will be used to measure these activities and contacts in interviews with inpatients. The ultimate aim will be to provide a more sophisticated way of costing inpatient services more accurately than the usually used cost per day.

A literature review of time and activity studies of inpatient mental health care was conducted to inform the development of the questionnaire along with information obtained from several meetings and interviews with staff members. The resulting draft was refined following two focus groups with staff members.

A feasibility study of 25 inpatients was conducted on seven wards to check the appropriateness of the instrument. The final draft of the questionnaire is a 4-5 page instrument that can be used to obtain the relevant information from patients in a short period of time (5-10 min). This measure will be used within BETTER PATHWAYS and DOORWAYS.

“The Perceive project will, for the first time, enable us to investigate the activities that patients
are engaged in whilst on the wards. This will be invaluable for examining the costs of care.”

Paul McCrone

Citrine - additional information ... (click here)

Literature review

Questionnaire

The first section on the Citrine measure records the number of activities that service users have used. Each ward has a different range of activities and these specific activities are referred to when using the questionnaire.
The second section records contacts with specific staff members.
The final section records details of close observations.

Focus Groups

Two focus groups were held – one with occupational therapists and the other with staff from one of the SLaM wards.
The groups commented on the content of the questionnaire and the feasibility of using it to collect data from service users.

Testing of Citrine

The Citrine measure was used in interviews with 25 inpatients from seven wards.
Where possible the data on the use of activities were checked against registers completed by staff.

Costing of activities and services

Details of staff time and material costs for each activity have been collected. Total costs have then been divided by use of activities to generate a cost per person.
Costs for contacts with staff have been estimated using standard unit costs produced by the University of Kent.
Total costs per service users are being analysed. Demographic and clinical predictors of cost will be identified and we will combine cost data with information on outcomes in the form of a cost-effectiveness analysis.

Past staff
Jessica Sharac (Research Worker)

For further information, please contact:
Ramon Sabes-Figuera, Research Worker on 0207 848 0503 or fill the contact form here.
Paul McCrone, Reader in Health Economics on 0207 848 0874 or fill the contact form here.