A unique urban state hospital: partial-hospital programs reduce full-time bed occupancy.
This paper describes a complex treatment system which serves a large urban population with a very small number of inpatient beds. From its very outset, the South Beach Psychiatric Center, a state facility in New York City, was determined to treat its patients with minimal use of inpatient bed occupancy. As a result, it started with a large outpatient program, in which day hospitals played a critical role. The aim was to treat patients on their home turf and, thus, to limit inpatient bed use to the period when the patient was out of control and a danger to self or others. Partial-hospitalization (PH) literature is replete with articles about utilization and underutilization [see Kennedy, L. L., A Bibliography on Partial Hospitalization, American Association for Partial Hospitalization (AAPH), Washington, D.C., 1986, pp. 1-70; Proceedings of the Annual Conference on Partial Hospitalization, Washington, D.C., 1976-1986; Wilner, M. (ed.), AAPH Newsletter, AAPH, Washington, D.C.] There are many discussions about the appropriate use of the PH program, how to get the program reimbursed, and how to get referrals to the program. Often, a pragmatic, although inefficient and sometimes very wrong, decision is made that, in the absence of a proper choice of treatment modalities, one judges the best referral to be the one that is available. South Beach therefore presents a useful study because it has a very wide range of treatment modalities: inpatient acute, intermediate, and chronic beds, admitting services, clinics, day hospitals (adolescent, adult, geriatric, acute, chronic), varieties of residences including quarter-way housing and supervised and unsupervised apartments, etc.(ABSTRACT TRUNCATED AT 250 WORDS)
D001509:Bed Occupancy; D002391:Catchment Area, Health; D003156:Community Mental Health Services / Q000706:statistics & numerical data*; D003631:Day Care, Medical / Q000706:statistics & numerical data*; D006743:Hospital Bed Capacity, under 100; D006779:Hospitals, Public / Q000458:organization & administration*; D006783:Hospitals, State / Q000458:organization & administration*; D009519:New York City; D014505:Urban Population