Utilization of psychiatric in-patient care among new patients in a comprehensive community-care system: a 3-year follow-up study.
Utilization of psychiatric in-patient care among 537 new patients was studied in the Department of Psychiatry in Oulu, Finland, during a 3-year follow-up period. Hospitalization during the second and third years of the follow-up was predicted by hospitalization and number of emergency out-patient contacts during the first year of the study, diagnosis of functional psychosis or personality disorder, and previous in-patient care. In total, 5% of the cohort fulfilled our criteria for 'revolving-door' patients. The 'revolving-door' phenomenon was associated with in-patient care at the first contact with the psychiatric services and diagnosis of psychosis or personality disorder. In total, 2% of the cohort became long-stay hospital patients, and this was predicted by psychosis diagnosis. The clinical implications of these findings are that increased attention should be paid to the first assessment of new patients and to the interaction between psychiatric services and patients during the first year of care.
Saarento
O
O
Department of Psychiatry, University of Oulu, Finland.
Nieminen
P
P
Hakko
H
H
Isohanni
M
M
Vaisanen
E
E
D000293:Adolescent; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003156:Community Mental Health Services / Q000706:statistics & numerical data*; D003191:Comprehensive Health Care / Q000706:statistics & numerical data*; D005260:Female; D005387:Finland / Q000453:epidemiology; D005500:Follow-Up Studies; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000523:psychology / Q000534:rehabilitation; D008875:Middle Aged; D010359:Patient Readmission / Q000706:statistics & numerical data*; D010554:Personality Disorders / Q000453:epidemiology / Q000523:psychology / Q000534:rehabilitation; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D011594:Psychometrics; D011618:Psychotic Disorders / Q000453:epidemiology / Q000523:psychology / Q000534:rehabilitation