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[Mediocre quality of discharge reports concerning psychiatric patients]
E W Beyaert1, M M Ubbink, A J Kaasenbrood
1Psychiatrisch Centrum Amsterdam, Valeriuskliniek.
Objective:
Determination of the quality of discharge letters concerning psychiatric patients.
Design:
Descriptive.
Setting:
29 community mental health clinics in The Netherlands.
Method:
420 hospital discharge letters were examined according to 13 quality criteria (reply time, legal status of the patient, reason for hospitalization, heteroanamnesis, source of income, alcohol use, drug use, physical findings, approach, structural diagnosis, DSM-III-R diagnosis, number of words, signature by psychiatrist) derived from a Dutch guideline for discharge letters.
Results:
The letters did not reach the aftercare attendant in time. The length of the letters was usually within 1050 words. Some formal criteria, like classification according to the DSM-III-R and signature were mostly met (in 67.1% and 90.9% of the letters). Important other information (for instance about a heteroanamnesis (24.8%), the source of income (23.1%), the use of alcohol (24%) or drugs (14.7%) and how to cope with the patient (8%)) were not sufficiently mentioned.
Conclusion:
The quality of hospital discharge letters from community mental health clinics in The Netherlands was insufficient. Adequate exchange of information is essential to guarantee good care for psychiatric patients. Improvement of the quality of hospital discharge letters is therefore highly advisable.