[Pathways of psychiatric in-patients].
OBJECTIVE
Pathways of psychiatric in-patients before and after their hospital stay should be evaluated.


METHODS
Based on data of the psychiatric basic documentation of 4066 patients, predictors of type of referral as well as outpatient aftercare were analysed by means of logistic regression.


RESULTS
42.5 % of patients were admitted without any medical sending, 18.4 % by a general practitioner, and 9.8 % by a psychiatrist in private practice. Patients referred by a general practitioner suffered more frequently from affective disorders (Odds Ratio = 4.0) or schizophrenia (OR = 3.3), and were residents of a senior citizen home (OR = 3.5). Inpatients sent by a psychiatrist were more often residents of a sheltered home (OR = 2.8), had a present episode lasting more than three months (OR = 1.9) and psychopharmacological pre-treatment with atypical antipsychotics (OR = 1.6) or SSRI (OR = 1.8). Outpatient aftercare was recommended to 83.1 % of in-patients: Aftercare by a general practitioner was more frequent in patients with addiction disorders (OR = 2.0) and elderly patients (OR = 1.03). Referral by a psychiatrist in private practice (OR = 4.5) as well as schizophrenia (OR = 3.3) or affective disorders (OR = 2.4) led more often to an outpatient aftercare by a psychiatrist.


CONCLUSIONS
Beside therapeutic requirements the referring person predicted the type of outpatient aftercare.
Hübner-Liebermann
Bettina
B
Klinik und Poliklinik für Psychiatrie und Psychotherapie der Universität am Bezirksklinikum Regensburg. bettina.huebner-liebermann@medbo.de
Spiessl
Hermann
H
Cording
Clemens
C
D000328:Adult; D000359:Aftercare / Q000706:statistics & numerical data; D000368:Aged; D003299:Cooperative Behavior; D005194:Family Practice / Q000706:statistics & numerical data; D005260:Female; D005858:Germany; D006801:Humans; D016015:Logistic Models; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000534:rehabilitation; D008875:Middle Aged; D019964:Mood Disorders / Q000453:epidemiology / Q000534:rehabilitation; D010343:Patient Admission / Q000706:statistics & numerical data*; D010348:Patient Care Team / Q000706:statistics & numerical data; D010351:Patient Discharge / Q000706:statistics & numerical data; D011570:Psychiatry / Q000706:statistics & numerical data; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012559:Schizophrenia / Q000453:epidemiology / Q000534:rehabilitation; D012959:Socioeconomic Factors