I’m often asked why Kartini Clinic doesn’t offer residential treatment.
It’s a great question. After all, the industry has seen increased integration over the past several
years, bringing inpatient (IP), residential (Res), partial hospitalization/intensive outpatient
(PHP/IOP) levels of care all under one roof.
And there is a lot to be said for a vertically integrated treatment model, including continuity of
care, a consistent treatment experience, and assurances to families and patients that the
appropriate level of care will be available within a single treatment program.
So why has Kartini Clinic chosen to focus exclusively on the PHP/IOP level of care?
Family Centered Treatment
The single most important reason is our patient population. Treating kids is all we do. And for
this population the clinical evidence is clear; the most effective treatment we currently know of
involves the family (and not just parents or guardians, but siblings too, if present).
Kartini Clinic’s PHP program involves families in ways that simply aren’t possible under a IP/Res
model (even with increasing use of virtual sessions involving family members). For example, our
patients are at home for evening meals and on weekends. This is when in fact a lot of treatment
and learning takes place. Crucially, it means that upon discharge, parents and families are often
better prepared for the next phase of recovery and healing.
High Acuity PHP
A second reason for our focus on PHP is the specific kind of PHP program we offer. After all,
we’d be the first to acknowledge not every child is appropriate for a standard PHP level of care.
But Kartini Clinic’s PHP program is unusual: a medically based model allowing us to treat high
acuity patients most programs are simply not able to accommodate. Thanks to our highly
trained medical staff, for example, we are able to admit intubated patients and if necessary
maintain their NG tubes during treatment.
In our nearly three decades of clinical experience, we’ve found that a high acuity PHP program
can effectively treat the vast majority of children who would otherwise be referred to IP/Res level
of care, with all its additional complexity, cost, and lack of access across most of the country,
and cost.
Access to Treatment
There is one more important, albeit non-clinical, reason for our focus on PHP: it’s a much
simpler operating model. Simplicity in turn translates to less expensive. According to Project
Heal, residential treatment on average costs $2000 per day (IP is even more expensive). Kartini
Clinic’s daily PHP rate is typically a third of that. This means less expensive treatment for
families but also less expensive treatment for providers to deliver. PHP programs benefit from
lower capital requirements, lighter state regulations and fewer- though more highly trained
staff members at a time when staffing is a key operational challenge. There is no need for 24
hours care or to provide housing (Kartini Clinic does, however, partner with an excellent charity,
Ronald McDonald House, to house families who must travel to us for treatment). Ultimately,
good clinical outcomes are contingent on good access to treatment, and lowering costs means
lowering the barriers to access for most families.
The combination of these three reasons- better clinical outcomes, lower costs, and reduced
barriers to entry- is why at Kartini Clinic we have chosen to focus exclusively on the high acuity
PHP level of care.
