Factors contributing to frequent use of psychiatric inpatient services by schizophrenia patients.
BACKGROUND
Although present findings about frequent users of psychiatric inpatient services vary from study to study, some potentially important predictors of frequent use were extracted. The purpose of this study was to examine the potentially contributory factors of frequent use of psychiatric inpatient services by schizophrenia patients and to test the influence single factors have in an overall model.


METHODS
A total of 307 schizophrenia patients were interviewed five times with intervals of 6 months. Data were collected about service receipt and health care costs, strength of primary diagnosis and comorbidities, as well as about patients' needs for care and satisfaction with care. Patients with three or more psychiatric admissions within a 30-month period were defined as frequent users.


RESULTS
According to this criterion, 12% of the study population were frequent users. Compared with ordinary users, these patients accounted for significantly higher costs in hospital- and community-based care. Important predictors for frequent use of psychiatric inpatient services were the number of previous hospitalizations and current scores of psychopathology. In addition, a longitudinal analysis showed the importance of social factors for the use of psychiatric inpatient care. Therefore, a number of the frequent users' multiple admissions could also be caused by social problems.


CONCLUSIONS
The mental health system should, thus, provide well-directed community-based resources, which give frequent users support to solve their social problems.
Roick
Christiane
C
University of Leipzig, Dept. of Psychiatry, Johannisallee 20, 04317 Leipzig, Germany. roich@medizin.uni-leipzig.de
Heider
Dirk
D
Kilian
Reinhold
R
Matschinger
Herbert
H
Toumi
Mondher
M
Angermeyer
Matthias C
MC
D000293:Adolescent; D000328:Adult; D000368:Aged; D005163:Factor Analysis, Statistical; D005260:Female; D006778:Hospitals, Psychiatric / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008297:Male; D008605:Mental Health Services / Q000191:economics / Q000706:statistics & numerical data*; D008875:Middle Aged; D010359:Patient Readmission / Q000706:statistics & numerical data*; D010507:Periodicity; D011567:Psychiatric Department, Hospital / Q000191:economics / Q000706:statistics & numerical data*; D012307:Risk Factors; D012559:Schizophrenia / Q000191:economics / Q000503:physiopathology / Q000534:rehabilitation*