Compliance and Costs in a Case Management Model

Case management (CM) team models are a well-established mode for delivery of mental health services to individuals with serious and persistent mental illnesses. Although numerous aspects of CM models have been investigated, a neglected component is compliance to outpatient appointments. This pilot, quality assurance study examined the relationship between compliance to psychiatric outpatient appointments and costs in an integrated service delivery system using CM for treating seriously and persistently mentally ill individuals. Two groups of participants were randomly selected based on a single compliance data point and examined using cross-sectional and longitudinal methods. Results revealed relatively high compliance rates that were significantly different between groups over time. However, no differences in costs for services over time, and no demographic variables predictive of noncompliance (i.e., age, miles from residence to site, ethnicity, diagnostic group, level of functioning) were identified. Implications for CM in public mental health integrated service delivery systems, and quality assurance studies are discussed.