A Psychiatric Case Register in North-East Scotland

Baldwin, J. A.; Innes, George; Millar, W. M.; Sharp, Geoffrey A.; Dorricott, N. J.

doi:10.1136/jech.19.1.38

Cited by 17 publications

(10 citation statements)

References 6 publications

(3 reference statements)

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“…PROJECTED OUTCOME OF THE MENTAL HOSPITAL POPULATION OF 1963 The earliest year for which sufficientlydetailed data could be obtained to carry out a reasonably accurate computation was 1963, the first year of operation of the psychiatric case register (Baldwin, Innes, Millar, Sharp, and Dorricott, 1965). Accurate information on admissions for the period 1956 to 1961 was kindly made available from the Scottish Home and Health Department.…”

Section: Resultsmentioning

confidence: 99%

“…Cross and Yates (1961) reported broadly similar estimates based on the Birmingham region. Criticisms of the estimates in the Hospital Plan emphasized the regional variation in current bed provision and the self-fulfilling character of prophecies of this kind when they are acted upon (Baldwin, 1963;Rehin and Martin, 1963), and the low expectation of separation from hospital by death or discharge of the high proportion of relatively young long-stay patients (Gore and Jones, 1961). Earlier optimism about the possibilities of rehabilitation of long-stay patients and reduction of requirements for long-term beds (Cooper and Early, 1961; Norton, 1961) has been tempered by more recent studies which have expressed doubt as to the likelihood of fulfilment of the original estimates (Hassall and Hellon, 1964;Early and Magnus, 1966).…”

mentioning

confidence: 99%

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Estimation of the outcome of a standing mental hospital population.

Baldwin¹,

Hall²

1967

Journal of Epidemiology & Community Health

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A review of surveys of mental hospital populations in Britain in the 1960s carried out for planning purposes reveals conflicting conclusions about the likely requirement for mental hospital beds over the next 15 to 20 years-the period over which estimates are needed for planning facilities. The (Baldwin, 1963;Rehin and Martin, 1963), and the low expectation of separation from hospital by death or discharge of the high proportion of relatively young long-stay patients (Gore and Jones, 1961). Earlier optimism about the possibilities of rehabilitation of long-stay patients and reduction of requirements for long-term beds (Cooper and Early, 1961; Norton, 1961) has been tempered by more recent studies which have expressed doubt as to the likelihood of fulfilment of the original estimates (Hassall and Hellon, 1964;Early and Magnus, 1966). It has also been shown that large differences exist in the behaviour of individual hospitals and of age and sex groups within hospitals, so that a uniform measure of bed needs could be misleading (Hassall, Spencer, and Cross, 1965).The problem of projecting the future size and structure of a mental hospital population on the basis of past and current use is usually subdivided into consideration of two interrelated processes:(1) The expected trend in the number of future admissions and their duration of stay or bed usage.(2) The expected attrition of the standing mental hospital population existing at the beginning of the projection period by death or discharge. This paper deals exclusively with the second of these processes.Tooth and Brooke (1961) based their calculation on the annual rate of separation (i.e. discharge and death) of the standing long-stay hospital population (over 2 years) at the end of 1954, assuming a linear fall to extinction in 16 years. It was subsequently pointed out that the assumption of linear attrition was almost certainly incorrect even on the basis of the original data (Lindsay, 1962). Lindsay showed that application of the annual separation rates to the patients in the original standing long-stay population remaining in hospital at the end of each year would represent a decreasing geometric series and not an arithmetic series, so that projection would result in a curve yielding a quarter of the patients remaining after 20 years, i.e. by 1974 . Norton (1961 had also projected in a curvilinear fashion from data on actual separation experience over 6 years.In order to improve the accuracy and usefulness of projections of this kind, a detailed study was undertaken to develop a method of forecasting which would make use of direct estimates of the probability of separation occuring after specified lengths of stay in hospital for any defined group of patients, such as an age, sex, or diagnostic group. A further objective of the study was to allow for the effect of ageing of the population remaining in hospital, so that the age composition of the residue could also be anticipated for any projection period. METHODPerhaps the most obvious approach to this prob...

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Section: Resultsmentioning

confidence: 99%

mentioning

confidence: 99%

Estimation of the outcome of a standing mental hospital population.

Baldwin¹,

Hall²

1967

Journal of Epidemiology & Community Health

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“…2. The overall average ratio of 17.4 beds/1,000 elderly falls slightly short of the figure one would obtain by adding (a) the North West Metropolitan Regional Hospital Board target of 10 geriatric beds/1,000 elderly, and (b) the Scottish Report requirement of 8.4 psycho-geriatric beds/1,000 elderly found from the study of the North East region of Scotland report and quoted in the Scottish report on the services for the elderly with mental disorder [3],…”

Section: Resourcesmentioning

confidence: 79%

“…And although there is evidence of fewer younger patients growing old in psychiatric hospitals, it seems all too likely that the consequent saving of beds will be taken up by the increasing psycho-geriatric demands of an ageing population [10]. There is no evidence that the proportion of elderly in psychiatric hospitals is diminishing, but some that it is increasing, except where restricted as an act of policy [2,3,11], It seems to us indisputable that the new psychiatric wings in district general hospitals will be totally inadequate to meet the psycho-geriatric demand, even with eventual help from special hostels and the planned increase in geriatric beds. This leads to the conclusion that the psychiatric hospital still has an important contribution to make in this respect, provided it is working as part of a comprehensive psychiatric service, with respon sibility for other areas of psychiatry as well as that of psycho-geriatrics.…”

Section: Recommendationsmentioning

confidence: 99%

Planning of Psycho-Geriatric Care

Andrews¹,

Bardon

Gander³

et al. 1972

Geront clin

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Three Psychiatrists and three Geriatric Physicians working in a Regional Hospital Board area have investigated the problem of Psycho-Geriatric care. They have made suggestions with regard to areas of clinical responsibility based on needs and behaviour rather than precise academic diagnoses. They have investigated psychiatric and geriatric resources available in their areas, and They have made recommendations with regard to the total numbers of beds needed, but have not made precise recommendations about the numbers required for residential hostels, geriatric units or psychiatric hospital accommodation respectively.

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“…Errors may stem from any of the four stages of data collection and recording i.e. from the patient, recorder, data-collection procedure or system design (Baldwin et al 1965). For example, diagnoses might be inaccurate if operationalised diagnostic criteria are not used.…”

Section: Discussionmentioning

confidence: 99%

Database use in psychiatric research: An international review

Higgins

Howard²

2005

Eur. J. Psychiat.

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-Objective: Whilst database use for the purposes of audit is well established amongst clinicians, their research potential has yet to be fully realised. This review provides an international perspective on research using databases in psychiatry, considering the advantages and constraints of their use.Method: Large databases used in psychiatric research were identified through a systematic search of MEDLINE and EMBASE databases. The types of research conducted with these databases were then grouped into categories for discussion. A narrative synthesis of results is presented, illustrated with examples.Results: Research identified included pharmacoepidemiology, perinatal, aetiological, suicidology and health service research.Conclusions: Databases have been used to address a range of questions in psychiatry, often by employing linkage between clinical and national administrative databases. The success of such research is not only dependent on appropriate methodology and database design, but also on clinician commitment to data entry. Further exploitation of linkage potential between databases is envisaged, alongside international development of clinical databases designed with the purpose of research in mind.

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A Psychiatric Case Register in North-East Scotland

Cited by 17 publications

References 6 publications

Estimation of the outcome of a standing mental hospital population.

Estimation of the outcome of a standing mental hospital population.

Planning of Psycho-Geriatric Care

Database use in psychiatric research: An international review

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