[Consequences of decentralization on the basis of a psychiatric department in the upper austrian salzkammergut].
OBJECTIVE
To describe the changes of utilization of a psychiatric department following its decentralization into an Upper Austrian region, the Salzkammergut.


METHODS
9 months before and after decentralization all kinds of contacts to psychiatric patients (inpatients, outpatients, day clinic patients, patients of consulting psychiatric service) regarding frequency of contacts, case numbers and diagnosis have been evaluated. For the inpatients their legal status was recorded.


RESULTS
Since the establishment of the decentralized psychiatric department an increase in the frequency of admissions of inpatients up to 157 % could be revealed. Depressive disorders showed the largest increase of admissions (204 %), remarkable increase was also seen in substance use disorders, neurotic and organic disorders (between 171 % and 183 %). Changes also emerged concerning the legal status of the patients with a decrease of the percentage of involuntary admissions from 26.5 % prior to decentralization to 20.7 % thereafter. Among the patients seen by the consulting service length of stay was higher than usually seen on somatic wards as there was a very high proportion of patients with depressive syndromes.


CONCLUSIONS
Within the context of decentralization provision of psychiatric care seems to be improved. Treating more patients with depressive and neurotic disorders the staff of the psychiatric ward was confronted to apply more psychotherapeutic interventions to meet the patient's neurotic and suicidal behaviour.
Silberbauer
Christoph
C
LKH Gmundnerberg und LKH Vöcklabruck, Psychiatrische Abteilung, Germany. Christoph.Silberbauer@gespag.at
Rittmannsberger
Hans
H
D001317:Austria; D002497:Centralized Hospital Services / Q000706:statistics & numerical data*; D003134:Commitment of Persons with Psychiatric Disorders / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D006801:Humans; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D010343:Patient Admission / Q000706:statistics & numerical data; D011057:Politics; D011567:Psychiatric Department, Hospital / Q000706:statistics & numerical data*; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D014600:Utilization Review