[Relapse as quality indicator in psychiatric treatment].
BACKGROUND
Efficiency and productivity expressed by length of hospitalisation, number of admissions, treated patients per time unit, and cost in NOK are incomplete measures for quality in a medical context. These measures should be supplemented by measures of results based on the course of illness for specific diagnostic categories. Few psychiatric institutions, including outpatient units, record the course of illness on a regular basis.


METHODS
A review of the literature shows that rough measures of results, for instance readmission rates, often form the basis for evaluation of course/treatment results. The article gives examples of measures like readmission rates and more scientific measures such as Positive and negative syndrome scale (PANSS) used to measure results in a Norwegian psychiatric hospital.


RESULTS
Of all first time admitted patients to Rogaland Psychiatric Hospital in 1985 and 1990, 40% of patients diagnosed with schizophrenia were readmitted after one year. For first time admitted patients from 1993 and 1994, the remission rate was 56% measured by PANSS.


CONCLUSIONS
The results of the treatment of first time admitted patients with a schizophrenia diagnosis were poorer than what is suggested possible through studies of optimal treatment, where the remission percentage is estimated to be 80% after one year. Rough measures of results, like readmission, do not seem to differ considerably from the results measured by PANSS. Norwegian psychiatric institutes are recommended to monitor the quality of treatment through a systematic recording of relapse among patients with a first time schizophrenia diagnosis.
Johannessen
J O
JO
Rogaland psykiatriske sjukehus, Stavanger. jo.johannessen@rps.netpower.no
Larsen
T K
TK
D005500:Follow-Up Studies; D006778:Hospitals, Psychiatric / Q000592:standards; D006801:Humans; D001523:Mental Disorders / Q000175:diagnosis / Q000628:therapy*; D008605:Mental Health Services / Q000592:standards*; D009664:Norway; D010359:Patient Readmission; D019984:Quality Indicators, Health Care; D012008:Recurrence; D012559:Schizophrenia / Q000175:diagnosis / Q000628:therapy*