以成本效果分析方法，比較以醫院為基礎居家照護模式與傳統門診追蹤模式精神疾患病人之達成成果。採回溯性雙組後測之研究設計，對象採自某醫學中心精神科提供居家照護二次以上之精神病患40名為居家照護組，以及與其同期出院但僅接受傳統門診追蹤之精神病患40名為傳統照護組。研究方法以結構式問卷，面對面訪談方式收集病患之疾病維持行為、精神症狀、社會功能及服務滿意度等四種效果指標，並收集費用資料，每位病人之費用為各項精神科服務費用之總合。研究結果顯示：居家照護組之成本效果比值為4.3，傳統門診追蹤之成本效果比值為13.5，居家照護組之病患在疾病維持行為方面，有較高的門診追蹤固定性、服藥遵從性等，同時亦具較輕的精神症狀、較佳的社會功能及較高的服務滿意度，故而以醫院為基礎之居家照護模式較具成本效果優勢。本研究證實「以醫院為基礎之精神科居家照護」確可有效地提高精神病患之治療效益，研究結果提供政策制定者重新考量居家照護的資源分配。

The purpose of this study was to compare the outcomes of a hospital-based home-care model with those of a conventional outpatient follow-up for mentally ill patients in Taiwan by means of cost-effectiveness analysis. The study design was a two group post hoc design. We interviewed 40 mentally ill patients who were followed up in the psychiatric outpatient department. Another 40 mentally ill patients who participated in a hospital based home care program were also interviewed. The outcome measures we used for interviews were disease maintenance behavior, psychotic symptoms, social function, service satisfaction, and cost. The cost for each patient was the sum of costs for all direct mental health services. The cost-effectiveness ratio showed that the costs of the hospital-based home care model (4.3) were lower than those of conventional outpatient follow-up (13.5) and that over a one-year period, the hospital-based home care model was associated with improvements in mental conditions, social functional outcomes, and service satisfaction. The improved outcomes and the lower costs in the hospital-based home care program support the view that it is the most cost-effective of the two. Policy makers may consider this analysis as they allocate resources and develop policy for the care of mentally ill patients.