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[In-hospital day for patients connected with the District Psychiatric Center in Svendborg. A controlled study]
A B Christensen1, E M Rasmussen, M A Brødsgaard
1Psykiatrisk afdeling P., Svendborg Sygehus.
Insights
District psychiatric centers can reduce patient bed-days through effective aftercare. However, severely ill patients still require periodic hospital admissions, even with specialized treatment models.
Area of Science:
- Psychiatry
- Health Services Research
Background:
- District psychiatric centers provide long-term care.
- Assessing the impact of community-based psychiatric services on hospital resource utilization is crucial.
Purpose of the Study:
- To evaluate the effect of district psychiatric treatment on patient bed-day utilization.
- To compare bed-day employment before and after the implementation of enhanced aftercare services.
Main Methods:
- A before-and-after study design was employed.
- Bed-day and admission data were analyzed for patients with over three years of connection to a district psychiatric center.
- A control group was used for comparison.
Main Results:
- A significant percentage reduction in bed-day employment was observed compared to the control group.
- Reductions were noted across diagnostic groups, particularly in long-term hospitalizations and readmissions.
- Least ill patients showed marked bed-day reduction, likely due to continuous post-discharge care.
Conclusions:
- District psychiatric treatment, including aftercare, can effectively reduce overall patient bed-day utilization.
- Severely ill psychiatric patients continue to necessitate periodic hospital admissions.
- Current aftercare models like the "Svendborg Model" do not eliminate the need for hospitalization for the most severely ill.
Abstract:
As of 31.12.1990, the employment of bed-days and admissions was calculated for patients who had been connected with a district psychiatric centre for more than three years. A before-and-after comparison revealed a percentage reduction in the employment of bed-days as compared with a control group. This corresponds to the findings in other investigations. In the before-and-after analysis, various reductions are described according to the diagnostic groups. The reduction in bed-day employment consisted mainly of fewer readmissions and reduction in the group of long-term hospitalisations. A reduction also occurred in the group of patients who could characterized as least ill. In this group, a marked percentage reduction in bed-days was observed as compared with the control group and this was probably due to the good and continuous treatment after discharge offered by the district psychiatric centre. This investigation revealed that the employment of bed-days for a patient population receiving district psychiatric treatment after discharge can be reduced. Nevertheless, the most severely ill patients will still require periodic admission to hospital. The value of treatment after discharge of the "Svendborg Model" type does not provide scientifically valid arguments that hospital admission can be avoided where the most severely ill patients are concerned.