Discharges of patients from public psychiatric hospitals in Italy between 1994 and 2000.
BACKGROUND
Psychiatric hospitals in Italy had to be closed under a law dated 1994.


OBJECTIVE
To investigate the discharge of patients from public psychiatric hospitals.


METHODS
A total of 4492 patients from 22 psychiatric hospitals were described at recruitment and followed during the period 1994-2000. Their characteristics were investigated as determinants of discharge to community residential facilities for psychiatric patients versus other settings.


RESULTS
All 22 psychiatric hospitals closed between 1994 and 2000; 678 patients had died, and the remainder were discharged. Of these, 39% went to nursing homes, 29% to community residential facilities for psychiatric patients, 2% joined their family, less than 1% were settled in private independent accommodation, and 29% remained in the psychiatric hospital, although defined as discharged. Ten patients were recorded as missing when still in the psychiatric hospitals, none after discharge. Younger, more educated patients and patients from two of the four regions studied were more likely to be discharged to community residential facilities.


CONCLUSIONS
The majority of patients were discharged to highly supervised settings. The potential risk of abandonment due to deinstitutionalization was not observed in this population. The wide use of highly supervised settings can be explained by the patients' old age, but different local policies may have affected the discharge process.
D'Avanzo
Barbara
B
Laboratory of Epidemiology and Social Psychiatry, Mario Negri Institute, Milan, Italy. barbara@marionegri.it
Barbato
Angelo
A
Barbui
Corrado
C
Battino
R Nadia
RN
Civenti
Graziella
G
Frattura
Lucilla
L
D000328:Adult; D003688:Deinstitutionalization / Q000706:statistics & numerical data; D005260:Female; D006271:Health Facility Closure / Q000331:legislation & jurisprudence; D006302:Health Services Research; D006778:Hospitals, Psychiatric / Q000706:statistics & numerical data*; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge / Q000706:statistics & numerical data / Q000639:trends*; D010360:Patient Transfer / Q000706:statistics & numerical data