title: Heavy use of psychiatric inpatient care from the perspective of the patients affected.
abstract: BACKGROUND
  Patients who spend an above-average amount of time in inpatient care are termed heavy users. Up to this point, very little has been known about what drives these patients to their heavy use of inpatient treatment.
  
  
  OBJECTIVE
  For this reason, the present study investigates the causes for frequent inpatient admissions of heavy users from the perspective of the patients affected.
  
  
  METHODS
  Twenty heavy users who were identified in a quantitative preliminary study were interviewed using a qualitative analysis of the contents.
  
  
  RESULTS
  Heavy users housed in sheltered accommodation either experienced frequent inpatient stays because of their symptomatic burden, or because of poor integration in their residences. Among the heavy users living in private residences was a subgroup that compensated for the lack of support from the private sphere with frequent hospital visits. A second subgroup turned to hospital care only during acute relapse episodes. In a third subgroup, secondary substance abuse accounted for the high demand for inpatient treatment.
  
  
  CONCLUSIONS
  Findings suggest that, using community-based psychiatric support offers tailored to the needs of the heavy user subgroups, inpatient treatment could be avoided.
authors.affiliation: Universität Leipzig, Klinik und Poliklinik für Psychiatrie, Germany. roich@medizin.uni-leipzig.de
authors.forename: Christiane
authors.initials: C
authors.lastname: Roick
authors.forename: Anke
authors.initials: A
authors.lastname: Gärtner
authors.forename: Dirk
authors.initials: D
authors.lastname: Heider
authors.forename: Sandra
authors.initials: S
authors.lastname: Dietrich
authors.forename: Matthias C
authors.initials: MC
authors.lastname: Angermeyer
mesh_terms: D000328:Adult; D001294:Attitude to Health; D005260:Female; D006778:Hospitals, Psychiatric; D006798:Housing; D006801:Humans; D007297:Inpatients / Q000523:psychology*; D008297:Male; D001523:Mental Disorders / Q000523:psychology / Q000628:therapy*; D008875:Middle Aged; D017063:Outcome Assessment, Health Care