The effect of deinstitutionalization on the longitudinal continuity of mental health care in the Netherlands.
BACKGROUND
Deinstitutionalization has been accompanied by a decreasing continuity of care in a number of countries. This study evaluates the effects of the Dutch model for deinstitutionalizing mental health care.


METHODS
Details of users and their use of community- and hospital-based services between 1990 and 1999 were retrieved from the Groningen case register. The time between discharge from the hospital and the first subsequent community-based contact was the primary indicator for changes in continuity of care.


RESULTS
The total proportion of discharges from hospital-based mental health care followed within 6 months by community-based care increased by 11% due to the improved availability of day treatment and home treatment. In terms of median survival time, aftercare in the years 1998/1999 was delivered more than twice as fast as in the years 1990/1991.


CONCLUSIONS
Study results supported the hypothesis in Dutch deinstitutionalization policy that the continuity of mental health care would benefit as to its longitudinal dimension.
Department of Psychiatry, University of Groningen, 30.001, 9700, RB Groningen, The Netherlands. y.j.pijl@med.rug.nl
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Sytema
D003156:Community Mental Health Services / Q000458:organization & administration*; D003266:Continuity of Patient Care; D003688:Deinstitutionalization; D006778:Hospitals, Psychiatric / Q000458:organization & administration*; D006801:Humans; D001523:Mental Disorders / Q000453:epidemiology / Q000523:psychology*; D009426:Netherlands / Q000453:epidemiology