Utilisation of inpatient psychiatric services by people with illicit substance abuse in Switzerland.
OBJECTIVE
The study aims to examine the utilisation of inpatient psychiatric services by people with substance use disorders (SUD), and to identify factors that predict inpatient service use.


METHODS
Out of a sample of consecutively referred first-admitted patients from a catchment area in Switzerland, a cohort of 563 individuals with behavioural and mental disorders due to (illicit) substance use was followed over a period of 5 years by means of register data.


RESULTS
Every fourth individual of the first-admission sample was admitted for a SUD. Over the 5-year period, average number of inpatient episodes (1.7) was comparable to that of patients with other diagnoses; time in hospital, however, was by far shorter (cumulative: 21 days). 61.6% of the individuals with SUD were treated as inpatients only once; 41.4% were not regularly discharged. Clinical patient characteristics (psychiatric co-morbidity, admission state, clinical improvement during first inpatient stay) and treatment measures (psychotherapy during first inpatient stay, planned aftercare) were the most important predictors of inpatient psychiatric service use over the 5-year period. Associations with sociodemographic background factors were only weak.


CONCLUSIONS
These findings suggest that a high number of patients with SUD are contacting inpatient services, but retention in treatment so far is not sufficient for an adequate drug treatment. Efforts need to be intensified to advance the diagnostic process and to improve current treatment strategies in order to achieve better clinical outcomes.
Lay
Barbara
B
Research Unit for Clinical and Social Psychiatry, Psychiatric University Hospital, Militärstrasse 8, CH-8021 Zurich, Switzerland. barbara.lay@bli.unizh.ch
Lauber
Christoph
C
Stohler
Rudolf
R
Rössler
Wulf
W
D000293:Adolescent; D000328:Adult; D000359:Aftercare; D000368:Aged; D002648:Child; D015331:Cohort Studies; D003627:Data Interpretation, Statistical; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D013287:Illicit Drugs; D007297:Inpatients; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011567:Psychiatric Department, Hospital / Q000706:statistics & numerical data*; D011613:Psychotherapy; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders / Q000188:drug therapy / Q000628:therapy*; D013557:Switzerland; D013997:Time Factors
D013287:Illicit Drugs