An index of responsiveness to patient needs: the synchrony ratio (PSI)

Indicators of the effectiveness of mental hospitals currently in use have severe limitations. Admissions, discharges, and occupancy rates are affected by multiple factors and determined largely be institutional policies. A rapidly calculable measure of responsiveness to patient requests for hospital admission is described. The synchrony ratio (psi) requires only that the number of emergency room visits and admissions by known accurately. If hospitals override patient needs, this is reflected in declining psi values. The utility of the synchrony ratio has been tested in a comparison of a general hospital psychiatric service and community mental health center inpatient wards.