The Nordic Comparative Study on Sectorized Psychiatry: continuity of care related to characteristics of the psychiatric services and the patients.
The problem addressed in this paper is how continuity of care is related to characteristics of psychiatric services, previous events in a patient's pattern of care and patient characteristics. The present paper is a part of a Nordic Comparative Study on Sectorized Psychiatry in seven catchment areas in four Nordic countries. One-year-treated-incidence cohorts were used. Each patient was followed for 1 year after the first contact with the psychiatric service. Continuity of care was measured by the time from discharge from hospital to the first subsequent day-patient or outpatient contact. Notable findings were large differences in the continuity of care in the seven services, high proportions of discharges without any aftercare contacts and long time lags between discharges and aftercare contacts in most of the catchment areas. A Cox regression analysis revealed that aftercare following hospitalisation seems to be more probable if the outpatient services are located geographically close to the patients, if the hospitalisation lasted between 2 and 4 weeks, if there was a community care contact shortly before the hospital admission and if the patient is not retired and not divorced. Staff resources were not related to continuity of care.
Saarento
O
O
Department of Psychiatry, University of Oulu, Finland. outi.saarento@ppshp.fi
Oiesvold
T
T
Sytema
S
S
Göstas
G
G
Kastrup
M
M
Lönnerberg
O
O
Muus
S
S
Sandlund
M
M
Hansson
L
L
D000328:Adult; D000359:Aftercare / Q000458:organization & administration*; D000368:Aged; D000553:Ambulatory Care / Q000458:organization & administration; D015331:Cohort Studies; D003156:Community Mental Health Services; D003266:Continuity of Patient Care / Q000706:statistics & numerical data*; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000458:organization & administration*; D008875:Middle Aged; D010347:Patient Care Planning / Q000458:organization & administration; D010351:Patient Discharge / Q000706:statistics & numerical data; D010359:Patient Readmission / Q000706:statistics & numerical data; D012044:Regression Analysis; D012537:Scandinavian and Nordic Countries; D000078329:Workforce