title: Psychiatric bed utilization: 1896 and 1996 compared.
abstract: BACKGROUND
  The 1896 and 1996 populations of North West Wales are similar in number, ethnic and social mix and rurality, enabling a study of the comparative incidence and prevalence of service utilization over the course of a century.
  
  
  METHODS
  We collected records on all psychiatric admissions from North-West Wales in 1894-1896 and 1996. These were assessed and diagnosed by the responsible sector area consultant.
  
  
  RESULTS
  The data reveal substantially more patients admitted for all diagnoses in 1996. even when comparisons are restricted to detained patients. The incidence of hospitalization by detention for schizophrenia is slightly lower 1996 than in 1896 but the incidence of hospitalization is higher now than in 1996. The incidence of hospitalization by detention for non-affective disorder psychoses is the same in both 1896 and 1996 but there is a doubling of incidence of hospitalization. The incidence of hospitalization for bipolar disorders is similar in the two periods. Modern mental health services admit large numbers of personality disordered patients, where none were admitted 100 years ago.
  
  
  CONCLUSIONS
  Factors general to changing health care and expectations and others specific to mental health would appear to have led to the increase in rates of admissions observed in the modern period.
authors.affiliation: North Wales Department of Psychological Medicine, University of Wales College of Medicine and School of Sociology and Social Policy, Bangor.
authors.forename: D
authors.initials: D
authors.lastname: Healy
authors.forename: M
authors.initials: M
authors.lastname: Savage
authors.forename: P
authors.initials: P
authors.lastname: Michael
authors.forename: M
authors.initials: M
authors.lastname: Harris
authors.forename: D
authors.initials: D
authors.lastname: Hirst
authors.forename: M
authors.initials: M
authors.lastname: Carter
authors.forename: D
authors.initials: D
authors.lastname: Cattell
authors.forename: T
authors.initials: T
authors.lastname: McMonagle
authors.forename: N
authors.initials: N
authors.lastname: Sohler
authors.forename: E
authors.initials: E
authors.lastname: Susser
mesh_terms: D000328:Adult; D000368:Aged; D001509:Bed Occupancy / Q000639:trends*; D001714:Bipolar Disorder / Q000453:epidemiology; D015984:Causality; D005260:Female; D006778:Hospitals, Psychiatric / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D008875:Middle Aged; D010343:Patient Admission / Q000639:trends*; D010554:Personality Disorders / Q000453:epidemiology; D011618:Psychotic Disorders / Q000453:epidemiology; D012189:Retrospective Studies; D014600:Utilization Review; D014852:Wales / Q000453:epidemiology