The Nordic Comparative Study on Sectorized Psychiatry: patients who use only psychiatric in‐patient care in comprehensive community‐based services — a 1‐year follow‐up study

Abstract

In the present paper a sample of patients using psychiatric in-patient care only is characterized and analysed with regard to characteristics of the psychiatric services. This paper forms part of the Nordic Comparative Study on Sectorized Psychiatry, designed to investigate contact rates and use of psychiatric care by new patients in 7 catchment areas in 4 Nordic countries during a 1-year follow-up. One-year treated incidence cohorts were used. The logistic regression analysis revealed that the variable 'psychiatric service' was one of the statistically significant determinants of using only in-patient care during the follow-up. The diagnostic groups with the highest probability of using only in-patient care were dependencies and functional psychoses. The following factors were associated with a high risk of using only in-patient care: older age, being referred by another psychiatrist, having received previous psychiatric in-patient care, male sex, being retired, and not living with one's parents or a partner. Patients who used only in-patient care had fewer admissions and days in in-patient care than others during the 1-year follow-up period. Lack of 24-hour emergency services in out-patient care correlated positively with the use of only in-patient care.

Psychiatric admissions and hospitalization costs in bipolar disorder in Sweden

“…Earlier research has found that difficulties in recruiting psychiatric healthcare staff [94] and distance to psychiatric healthcare [95] can explain higher psychiatric morbidity in rural areas. Large differences in the availability and utilization of mental healthcare services can influence the rates of psychiatric morbidity and thereby differences in psychiatric morbidity between regions [96].…”

Community psychiatry in the Sub-Arctic. Experiences with the shift from hospital-based to community-based psychiatric services in Northern Norway

“…Regarding utilisation parameters, such as emergency admissions to inpatient care (Saarento et al, 1998a), proportion of patients who use only inpatient care. (Saarento et al, 1998b), emergency outpatient contacts (Saarento et al, 1998c), median length of stay (0iesvold et al, 1999) and readmissions (0iesvold et al, 2000), there were no significant differences between urban and rural areas.…”

Does deinstitutionalisation work? Relationships between psychiatric outpatient and inpatient care provision in a rural German catchment area

“…Tyrer et al [19] compared the clinical outcome and costs of care of psychiatric patients in London allocated to community-based multidisciplinary teams or to hospital-based outpatient care programmes after discharge from inpatient care; the clinical outcomes were similar but admission to hospital during follow-up was more likely in the hospital-based care group. In general, lack of 24-hour emergency settings correlates positively with the use of inpatient care alone [20] . It indicates that the extended availability of outpatient services in the community for people in crisis may facilitate the comprehensive utilization of mental health services [8] .…”