Review: day hospital is as effective as inpatient care but has lower costs for patients with acute psychiatric disorders.

Main results 9 trials (n=1568) met the selection criteria. Follow up duration ranged from 2–24 months. Sample sizes ranged from 90–378 participants. Individual patient data were obtained for 4 trials (n=646). Patients allocated to day hospital care had a longer duration of index admission than those allocated to inpatient care (table). Day hospital and inpatient care did not differ for total number of days in hospital (table). In 5 trials (n=667), day hospital and inpatient care did not differ for rates of readmission to day or inpatient care after discharge (p=0.4). In 1 trial (n=160), day hospital and inpatient care did not differ for all cause mortality (p=0.7). Of 5 trials reporting costs of care, 4 reported that day hospital care had lower costs for all psychiatric care (including hospital care) than inpatient care (cost reductions of 21–37%); 1 trial found no cost difference. Analysis of individual patient data in 3 trials showed that day hospital patients had more rapid improvement in mental status than inpatients, but did not differ for social functioning. Conclusions In patients with acute psychiatric disorders, day hospital is associated with a longer duration of index admission than inpatient care and is not more effective in reducing readmission rates or total number of days in hospital. Day hospital care is, however, associated with cost savings of 21–37% relative to inpatient care.