The Economics of Rehabilitation

¹ Research Assistant, St. Wulstan's Hospital, Malvern, Worcestershire
² Director of Rehabilitation, St. Wulstan's Hospital, Malvern, Worcestershire

The total cost of a psychiatric rehabilitation service for long-stay patients has been measured by studying the hospital's first 200 consecutively admitted patients and their careers over the ten years 1961-70.

Account has been taken of every known direct cost to the national economy, of which the Health Service cost is only a part. Account has also been taken of every known direct financial contribution to the economy by successfully resettled patients. No attempt has been made to include indirect costs or contributions.

The maintenance cost in the rehabilitation hospital was about 70 per cent higher throughout the period than the average cost in the hospitals from which the patients came. Despite this, the total net cost of the cohort under rehabilitation was 6 per cent less than it would have cost to keep all 200 patients throughout the ten years in their previous hospitals.

The extent to which the cost of additional resources has already been offset by some of the patients' success in achieving an independent life has therefore been demonstrated. The trend is likely to continue. All 200 persons who are the subjects of this study entered the decade under review as long-stay patients. Of these, 82 enter the subsequent decade as independent citizens. Their continuing independence is not only gratifying clinically but promises to offset even further the cost of the original investment in an additional rehabilitation service.