[Pathways of psychiatric in-patients]

Pathways of psychiatric in-patients before and after their hospital stay should be evaluated.

Based on data of the psychiatric basic documentation of 4066 patients, predictors of type of referral as well as outpatient aftercare were analysed by means of logistic regression.

42.5 % of patients were admitted without any medical sending, 18.4 % by a general practitioner, and 9.8 % by a psychiatrist in private practice. Patients referred by a general practitioner suffered more frequently from affective disorders (Odds Ratio = 4.0) or schizophrenia (OR = 3.3), and were residents of a senior citizen home (OR = 3.5). Inpatients sent by a psychiatrist were more often residents of a sheltered home (OR = 2.8), had a present episode lasting more than three months (OR = 1.9) and psychopharmacological pre-treatment with atypical antipsychotics (OR = 1.6) or SSRI (OR = 1.8). Outpatient aftercare was recommended to 83.1 % of in-patients: Aftercare by a general practitioner was more frequent in patients with addiction disorders (OR = 2.0) and elderly patients (OR = 1.03). Referral by a psychiatrist in private practice (OR = 4.5) as well as schizophrenia (OR = 3.3) or affective disorders (OR = 2.4) led more often to an outpatient aftercare by a psychiatrist.

Beside therapeutic requirements the referring person predicted the type of outpatient aftercare.