title: [Central to decentralized admission to the psychiatric hospital. Effects of changed admission circumstances on structure and process quality].
abstract: The study provides empirical data to compare different systems used for hospital admission procedures in a psychiatric clinic. The Psychiatric University Clinic Basel replaced its traditional central admission ward by direct admission to a number of different treatment settings. This change had consequences for both structural and procedural quality. More admissions occurred after prior notice had been given, and these admissions occurred more often at a time of day when more clinic staff were available. The rate of voluntary admissions increased, and the continuity of care, as measured by the number of transfers within the clinic during the first 5 days post-admission, was improved. These findings, which support an interpretation that the treatment conditions were improved, must be balanced against the drawback of delayed decision-making processes with, for example, longer waiting times for the patient. However, the continuity of therapeutic relationships can be increased through further changes in the procedural quality.
authors.affiliation: Psychiatrische Universitätsklinik, Basel.
authors.forename: H J
authors.initials: HJ
authors.lastname: Haug
authors.forename: L
authors.initials: L
authors.lastname: Bozinovski
authors.forename: P
authors.initials: P
authors.lastname: Eich
authors.forename: K
authors.initials: K
authors.lastname: Jawhari
authors.forename: F
authors.initials: F
authors.lastname: Müller-Spahn
mesh_terms: D000328:Adult; D002497:Centralized Hospital Services / Q000706:statistics & numerical data*; D005260:Female; D005858:Germany; D006778:Hospitals, Psychiatric / Q000706:statistics & numerical data*; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000628:therapy; D008875:Middle Aged; D010343:Patient Admission / Q000706:statistics & numerical data*; D010360:Patient Transfer / Q000706:statistics & numerical data; D011785:Quality Assurance, Health Care / Q000706:statistics & numerical data; D012017:Referral and Consultation / Q000706:statistics & numerical data