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.
Pijl
Y J
YJ
Department of Psychiatry, University of Groningen, 30.001, 9700, RB Groningen, The Netherlands. y.j.pijl@med.rug.nl
Sytema
S
S
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