Combined medical-psychiatric inpatient units: evaluation of the Centre for the Elderly.
Considering the large number of elderly patients in acute hospitals who receive medical as well as psychiatric treatment because of relevant comorbidity, adequate interdisciplinary treatment models have to be developed and applied. The Centre for Elderly, a cooperation project between the departments of geriatric and psychogeriatric medicine in a community hospital in Germany, was founded in 2000. In addition to traditionally structured units, the centre consists of interdisciplinary units. Patient-, staff- and hospital-related characteristics influenced by the reformation of both departments were evaluated by comparing hospital-based registry data records containing age, gender, main and minor diagnoses, length of stay and patient transferrals within the centre. Experts working at the centre were asked to take a stand on the development of the treatment quality, allocation of patients, diagnostic procedures, consultation services and information transmission. The number of admissions to the Centre for the Elderly increased within one year. The distribution of the main diagnose groups remained unchanged, with an overlap between the geriatric and psychogeriatric department consisting of the main diagnoses dementia and depression. The length of stay and the number of transferrals decreased significantly in both departments. The majority of the interviewed employees stated that the treatment quality and the allocation of patients were improved. We conclude that interdisciplinary treatment between the departments of psychiatry and geriatric medicine may contribute to the medical needs of subgroups of elderly inpatients suffering from medical-psychiatric comorbidity.
Maier
A B
AB
Leiden University Medical Center, Department of Gerontology and Geriatrics, 9600, 2300 RC, Leiden, The Netherlands. a.b.maier@lumc.nl
Wächtler
C
C
Hofmann
W
W
D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D003299:Cooperative Behavior; D003704:Dementia / Q000453:epidemiology; D003866:Depressive Disorder / Q000453:epidemiology; D003953:Diagnosis-Related Groups; D005852:Geriatric Psychiatry / Q000458:organization & administration*; D005853:Geriatrics / Q000458:organization & administration*; D006299:Health Services for the Aged / Q000458:organization & administration; D006754:Hospital Restructuring / Q000458:organization & administration*; D006764:Hospitals, Community / Q000458:organization & administration; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008875:Middle Aged; D009426:Netherlands; D010343:Patient Admission / Q000706:statistics & numerical data; D010348:Patient Care Team / Q000458:organization & administration*; D010360:Patient Transfer / Q000706:statistics & numerical data; D011567:Psychiatric Department, Hospital / Q000458:organization & administration*; D011785:Quality Assurance, Health Care / Q000458:organization & administration; D012042:Registries
Lancet. 2001 Apr 21;357(9264):1264-5
11418154
J Psychosom Res. 2000 Feb;48(2):149-55
10719131
Br J Psychiatry. 1981 Jan;138:17-20
7272607
Psychosomatics. 1985 Mar;26(3):193-5, 199-200, 208-9
3991860
Am J Psychiatry. 2000 Dec;157(12):1915-24
11097951
Aust N Z J Psychiatry. 2005 Sep;39(9):816-25
16168040
Psychosomatics. 1985 Mar;26(3):179-82, 185-6, 189
3991859
Psychol Med. 1999 Jul;29(4):823-32
10473309
Nervenarzt. 1993 Jan;64(1):53-61
8437648
Am J Psychiatry. 1985 Sep;142(9):1085-9
3927752
Arch Gen Psychiatry. 1979 Apr;36(4):414-9
426608
Psychiatr Prax. 2000 May;27(4):170-5
17195509
Gen Hosp Psychiatry. 1998 Mar;20(2):71-22
9582588
J Psychosom Res. 1988;32(4-5):541-9
3236278
Psychosomatics. 1998 May-Jun;39(3):273-80
9664774
Am J Geriatr Psychiatry. 1999 Winter;7(1):48-56
9919320
Med J Aust. 1994 Jun 6;160(11):671-5
8201999
Community Ment Health J. 1987 Spring;23(1):30-9
3608408
Aust N Z J Psychiatry. 1991 Sep;25(3):322-9
1845255
Age Ageing. 2005 May;34(3):205-7
15863403
Psychosomatics. 1992 Fall;33(4):376-86
1461963
Int J Psychiatry Med. 1995;25(2):137-72
7591491
Schweiz Med Wochenschr. 1977 Oct 1;107(39):1354-61
905815
Psychosomatics. 2001 Sep-Oct;42(5):377-81
11739903