The Effectiveness of a Peer-Staffed Crisis Respite Program as an Alternative to Hospitalization.
OBJECTIVE
This study assessed whether peer-staffed crisis respite centers implemented in New York City in 2013 as an alternative to hospitalization reduced emergency department (ED) visits, hospitalizations, and Medicaid expenditures for individuals enrolled in Medicaid.


METHODS
This study used Medicaid claims and enrollment data for January 2009 through April 2016 to estimate impacts on ED visits, hospitalizations, and total Medicaid expenditures by using a difference-in-differences model with a matched comparison group. The study sample included 401 respite center clients and 1,796 members of the comparison group.


RESULTS
In the month of crisis respite use and the 11 subsequent months, Medicaid expenditures were on average $2,138 lower per Medicaid-enrolled month and there were 2.9 fewer hospitalizations for crisis respite clients than would have been expected in the absence of the intervention (p<.01).


CONCLUSIONS
Peer-staffed crisis respite services resulted in lowered rates of Medicaid-funded hospitalizations and health expenditures for participants compared with a comparison group. The findings suggest that peer-staffed crisis respites can achieve system-level impacts.
['Bouchery|Ellen E|EE|', 'Barna|Michael|M|', 'Babalola|Elizabeth|E|', 'Friend|Daniel|D|', 'Brown|Jonathan D|JD|', 'Blyler|Crystal|C|', 'Ireys|Henry T|HT|']
D000293:Adolescent D000328:Adult D000488:Allied Health Personnel D004636:Emergency Service, Hospital D005260:Female D005102:Health Expenditures D006760:Hospitalization D006801:Humans D008297:Male D008484:Medicaid D001523:Mental Disorders D008875:Middle Aged D009519:New York City D010043:Outcome and Process Assessment, Health Care D010344:Patient Advocacy D010353:Patient Education as Topic D010379:Peer Group D012144:Respite Care D000073278:Self-Management D012944:Social Support D014481:United States D055815:Young Adult
Hospitalization Crisis intervention peer services