Patterns of care in patients discharged from acute psychiatric inpatient facilities

Preti, Antonio; Rucci, Paola; Gigantesco, Antonella; Santone, Giovanni; Picardi, Angelo; Miglio, Rossella; Girolamo, Giovanni de

doi:10.1007/s00127-009-0498-2

Cited by 26 publications

(25 citation statements)

References 52 publications

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“…As observed in other surveys [8,37], approximately one-third of patients did not participate in RF chores. In terms of institutional support/rehabilitation, most RF activities concerned facility management, and few were targeted at integrating patients within the local community.…”

Section: Residents' Clinical Features and Activity Levelssupporting

confidence: 67%

Is psychiatric residential facility discharge possible and predictable? A multivariate analytical approach applied to a prospective study in Italy

Girolamo

Candini

Buizza

et al. 2013

Soc Psychiatry Psychiatr Epidemiol

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Background A growing number of severely ill patients require long-term care in non-hospital residential facilities (RFs). Despite the magnitude of this development, longitudinal studies surveying fairly large resident samples and yielding important information on this population have been very few. Aims The aims of the study were (1) to describe the socio-demographic, clinical, and treatment-related characteristics of RF patients during an index period in 2010; (2) to identify predictors and characteristics associated with discharge at the 1-year follow-up; (3) to evaluate clinicians' predictions about each patient's likelihood of home discharge (HD). Methods A prospective observational cohort study was conducted involving all patients staying in 23 mediumlong-term RFs of the St John of God Order with a primary psychiatric diagnosis. A comprehensive set of sociodemographic, clinical, and treatment-related information was gathered and standardized assessments (BPRS, HO-NOS, PSP, PHI, SLOF, RBANS) were administered to each participant. Logistic regression analyses were run to identify independent discharge predictors. Results The study involved 403 patients (66.7 % male), with a mean age of 49 years (SD = 10). The participants' average illness duration was 23 years; median value for length of stay in the RF was 2.2 years. The most frequent diagnosis was schizophrenia (67.5 %). 104 (25.8 %) were discharged: 13.6 % to home, 8.2 % to other RFs, 2.2 % to supported housing, and 1.5 % to prison. Clinicians' predictions about HD were generally erroneous. Conclusions Very few patients were discharged to independent accommodations after 1 year. The main variables associated with a higher HD likelihood were: illness duration of \15 years and effective social support during the previous year. Lower severity of psychopathology and higher working skill levels were also associated with a significantly greater HD likelihood.

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Section: Residents' Clinical Features and Activity Levelssupporting

confidence: 67%

Is psychiatric residential facility discharge possible and predictable? A multivariate analytical approach applied to a prospective study in Italy

Girolamo

Candini

Buizza

et al. 2013

Soc Psychiatry Psychiatr Epidemiol

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“…As a positive treatment response is usually defined in the literature as greater than 20% reduction in BPRS (Lachar et al, 1999), our findings showed that a short LOS in our ward was highly effective. Our results are consistent with previous systematic reviews (Alwan et al, 2008;Johnstone and Zolese, 2009) and the two Italian surveys (Ballerini et al, 2007a(Ballerini et al, , 2007bBarbato et al, 2010;Preti et al, 2009), suggesting that a short hospitalization is sufficient for the majority of patients (Frieri et al, 2013).…”

Section: Discussionsupporting

confidence: 95%

Gender differences in 353 inpatients with acute psychosis: The experience of one Psychiatric Emergency Service of Turin

Montemagni

Frieri

Blandamura

et al. 2015

Psychiatry Research

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“…In Italy, patient characteristics differ between private and public (psychiatric) hospitals. Older patients are less likely to be unemployed and make more use of private services …”

Section: Resultsmentioning

confidence: 99%

Do private hospitals outperform public hospitals regarding efficiency, accessibility, and quality of care in the European Union? A literature review

Kruse

Stadhouders

Adang

et al. 2018

Health Planning & Management

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SummaryEuropean countries have enhanced the scope of private provision within their health care systems. Privatizing services have been suggested as a means to improve access, quality, and efficiency in health care. This raises questions about the relative performance of private hospitals compared with public hospitals. Most systematic reviews that scrutinize the performance of the private hospitals originate from the United States. A systematic overview for Europe is nonexisting. We fill this gap with a systematic realist review comparing the performance of public hospitals to private hospitals on efficiency, accessibility, and quality of care in the European Union. This review synthesizes evidence from Italy, Germany, the United Kingdom, France, Greece, Austria, Spain, and Portugal. Most evidence suggests that public hospitals are at least as efficient as or are more efficient than private hospitals. Accessibility to broader populations is often a matter of concern in private provision: Patients with higher social‐economic backgrounds hold better access to private hospital provision, especially in private parallel systems such as the United Kingdom and Greece. The existing evidence on quality of care is often too diverse to make a conclusive statement. In conclusion, the growth in private hospital provision seems not related to improvements in performance in Europe. Our evidence further suggests that the private (for‐profit) hospital sector seems to react more strongly to (financial) incentives than other provider types. In such cases, policymakers either should very carefully develop adequate incentive structures or be hesitant to accommodate the growth of the private hospital sector.

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Patterns of care in patients discharged from acute psychiatric inpatient facilities

Cited by 26 publications

References 52 publications

Is psychiatric residential facility discharge possible and predictable? A multivariate analytical approach applied to a prospective study in Italy

Is psychiatric residential facility discharge possible and predictable? A multivariate analytical approach applied to a prospective study in Italy

Gender differences in 353 inpatients with acute psychosis: The experience of one Psychiatric Emergency Service of Turin

Do private hospitals outperform public hospitals regarding efficiency, accessibility, and quality of care in the European Union? A literature review

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