An evaluation of a surveillance system for patients discharged from the acute psychiatry unit in southern Tasmania.
OBJECTIVE
The aim is to evaluate the current community follow-up, or health surveillance, system for patients discharged from the acute psychiatry unit into the community in southern Tasmania.


METHODS
We developed a conceptual model which considered community mental health follow-up as analogous to an epidemiological surveillance system. The surveillance system was evaluated by prospectively following recorded contacts between the system and a cohort of 100 patients consecutively discharged from the acute psychiatry unit. Main outcome measures were attendance at follow-up appointments, patient re-engagement and hospital readmission.


RESULTS
There is no formal system of follow-up and no policy relating to non-attenders of follow-up appointments after psychiatric hospitalisation. There is no defined role for private medical practitioners and agencies in the community. Of the 97 patients considered to need community follow-up, 11 patients were lost to follow-up after 3 months, while another 15 remained in the system because of hospital readmission. A further seven patients returned to the system during the following 2 years (six in year 1 and one in year 2) due to readmission. There is appropriate policy about the content and timing of discharge summaries; most summaries were sent promptly.


CONCLUSIONS
After discharge from the acute psychiatric unit, there was inadequate community follow-up of those patients for whom follow-up was considered necessary. Research is needed to determine whether increased patient follow-up is beneficial. Stakeholders should decide whether formal follow-up or health surveillance is necessary.
Sladden
M J
MJ
Discipline of General Practice, University of Tasmania, Hobart, Australia. M.Sladden@utas.edu.au
Thomson
A N
AN
D000293:Adolescent; D000328:Adult; D000359:Aftercare / Q000592:standards / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D001071:Appointments and Schedules; D019090:Case Management / Q000592:standards / Q000706:statistics & numerical data; D003266:Continuity of Patient Care / Q000592:standards / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000628:therapy*; D008605:Mental Health Services / Q000592:standards* / Q000706:statistics & numerical data; D008875:Middle Aged; D010351:Patient Discharge / Q000592:standards* / Q000706:statistics & numerical data; D010352:Patient Dropouts / Q000706:statistics & numerical data; D011159:Population Surveillance / Q000379:methods*; D011320:Primary Health Care / Q000706:statistics & numerical data; D011446:Prospective Studies; D011567:Psychiatric Department, Hospital / Q000592:standards* / Q000706:statistics & numerical data; D013223:Statistics as Topic; D013648:Tasmania