A prospective longitudinal study of utilization of a psychiatric hospital in Hordaland County, Norway, from 1985 to 2003.
BACKGROUND
In Norway, as in the rest of the Western world, during the last three decades there has been a reduction of psychiatric hospital beds and expansion of extramural mental services, more based on ideology than empirical research.


OBJECTIVE
To study the use of a psychiatric hospital before and after expansion of the outpatient psychiatric care in Hordaland County, Norway from 1985 to 2003.


METHODS
All patients admitted from a catchment area of 168,000 inhabitants were included in a prospective longitudinal study.


RESULTS
During the study period, there was a decrease in psychiatric hospital beds in the county. From 1991 to 2003, the annual number of outpatient consultations in District Psychiatric Centres more than doubled, but none of the four psychiatric hospitals in the county showed any decline in the number of admitted patients. Since 1995, there was a 100% increase in the annual number of stays, number of individual patients and number of first-stay patients admitted to the psychiatric hospital serving the inner-city area of Bergen, the main city in Hordaland, and the surrounding countryside. In this hospital, the annual number of patients with a drug/alcohol problem showed a fivefold increase. The same was the case for patients from the immigrant population. The annual number of first stays and hospital days for patients aged 20-29 years from the rural area increased more than twofold.


CONCLUSIONS
There is still an increased need for specialized inpatient hospital mental healthcare, despite the growth of the extramural mental health services.
Nome
Siri
S
Centre for Research and Education in Forensic Psychiatry, Division of Psychiatry, Haukeland University Hospital, Bergen, Norway. siri.nome@helse-bergen.no
Holsten
Fred
F
D000328:Adult; D000437:Alcoholism / Q000453:epidemiology* / Q000534:rehabilitation; D000553:Ambulatory Care / Q000706:statistics & numerical data / Q000639:trends; D001509:Bed Occupancy / Q000706:statistics & numerical data / Q000639:trends; D015897:Comorbidity; D003430:Cross-Sectional Studies; D006302:Health Services Research / Q000706:statistics & numerical data / Q000639:trends; D006742:Hospital Bed Capacity / Q000706:statistics & numerical data; D006766:Hospitals, County / Q000706:statistics & numerical data* / Q000639:trends*; D006778:Hospitals, Psychiatric / Q000706:statistics & numerical data* / Q000639:trends*; D006785:Hospitals, University / Q000706:statistics & numerical data* / Q000639:trends; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data / Q000639:trends; D008137:Longitudinal Studies; D001523:Mental Disorders / Q000453:epidemiology* / Q000534:rehabilitation; D009664:Norway; D010044:Outpatient Clinics, Hospital / Q000706:statistics & numerical data / Q000639:trends; D010343:Patient Admission / Q000706:statistics & numerical data / Q000639:trends; D010359:Patient Readmission / Q000706:statistics & numerical data / Q000639:trends; D011446:Prospective Studies; D012017:Referral and Consultation / Q000706:statistics & numerical data / Q000639:trends; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000534:rehabilitation; D014600:Utilization Review / Q000706:statistics & numerical data / Q000639:trends