title: No way out: the delayed discharge of elderly mentally ill acute and assessment patients in north and south Thames regions.
abstract: We examined the characteristics of patients occupying elderly-mentally-ill acute and assessment beds in all mental health units within North and South Thames Regions; the proportion of patients defined as no longer requiring acute care (inappropriately located); and the unmet need for alternative service provision these patients required. Of the 1510 patients surveyed, 24.4% (n = 368) were defined as inappropriately located. For inappropriately located patients unable to be discharged home most (52.8%, n = 154) required residential care or nursing-home provision. A large proportion of these patients were very elderly (aged 85+ years), had dementia, and required high levels of supervision. This study indicates that purchasers, mental health service managers and social services departments should devise a more appropriate mix of inpatient and community provision. Particular emphasis needs to be placed on the greater provision of residential care and nursing homes with an appropriate skill-mix to care for this complex care group.
authors.affiliation: Department of Public Health, Kensington & Chelsea and Westminster Health Authority, London.
authors.forename: J
authors.initials: J
authors.lastname: Koffman
authors.forename: N J
authors.initials: NJ
authors.lastname: Fulop
authors.forename: D
authors.initials: D
authors.lastname: Pashley
authors.forename: K
authors.initials: K
authors.lastname: Coleman
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D003704:Dementia / Q000453:epidemiology* / Q000523:psychology / Q000534:rehabilitation; D004739:England / Q000453:epidemiology; D005260:Female; D015577:Geriatric Assessment / Q000706:statistics & numerical data*; D006300:Health Services Misuse / Q000706:statistics & numerical data; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008329:Managed Care Programs / Q000706:statistics & numerical data; D001523:Mental Disorders / Q000453:epidemiology* / Q000523:psychology / Q000534:rehabilitation; D010351:Patient Discharge / Q000706:statistics & numerical data*