Efficiency in psychiatric treatment - the case of treating personality disorders

We want to study efficiency in treatment of psychiatric patients by utilising measures of input and outcomes on the indvidual level. The objective is to analyse variation in efficiency between treated patients and treatment units, and second to analyse th e association between characteristics of patients and the organisational environment - and effeciency. We will study the case of treating patients with personality disorders. It is shown that intensive time-limited day hospital treatment followed by a ph ase of outpatient continuation therapy, has positive effect for the patients. The question whether treating personality disorders could be performed with higher efficiency has not been analysed to the same extent. Major challenges when analysing efficie ncy of health services are multiple and hetergogenous outputs and the identification of outcomes for the patients. When information about health effect on the patient level is missing, intermediate outputs are often used. A way to alleviate this measureme nt is to study less aggregated and more homogenous units and use information about effect on the patient level. The study will use data from the Network of day treatment units in Norway for the period of 1993-2004. The material includes information about patients treated in this period at eight different treatment units (N=2572). Additional information about organisational environment will be collected. Data Envelopment Analysis will be utilised to identify efficient and non-efficient treated patients, while regression will be used to analyse the link between efficiency and explanation factors. There are major methodological challenges concerning how to interpret changes in outcome measurement on the patient level, as well as weigthing between different outcomes, and discriminating between different input-output models. The project will lead to a doctoral thesis based on five papers of which one is accepted and one is submitted.