A perfected mismatch: Are prevention and recovery care services really comparable to acute inpatient units?

A recent matched pairs analysis of Prevention and Recovery Care Services (PARCS) concludes that they offer a less restrictive and cost-effective alternative to inpatient facilities for eligible patients (Farhall et al., 2021). This study explored whether PARCS recovery-orientated care model admissions led to better outcomes, i.e., less subsequent 24-hour care requirements and less
Inpatient Treatment Orders (ITOs) or Community Treatment Orders (CTOs). However, we observe the two patient cohorts may have initially differed in terms of clinical risk, despite the attempted matching process. Thus, it is debatable whether acute beds can be effectively substituted by subacute residential beds, such as PARCS (Allison et al., 2014). A review by the Victorian Department of Health and Human Services (DoH), published in 2016 found that the ‘use of hospital-based services has not decreased with the introduction of PARCS’ and that PARCS had lower than expected occupancy rates, averaging only 72% between 2009/2010 and 2013/2014 (Department of Health and Human Services, 2016).