title: Referral to Inpatient Treatment Does not Necessarily Imply a Need for Inpatient Treatment.
abstract: We analyzed the dispositional decisions taken in a unit for clinical decision making (UCDM) which was set up to examine all emergency inpatient referrals to a psychiatric hospital. Hospitalization proved unnecessary for at least 17 % of the N = 2,026 inpatient referrals over a one year period. Instead, these patients were admitted to day-hospitals or outpatient treatments, resulting in annual cost savings of approximately <euro>3.3 million. Merely 8 % of those non-admitted patients had to be hospitalized within 28 days of the decision for non-admission being taken. Thus, a specialized UCDM run by clinical experts can help identify cost-effective alternatives to hospitalization.
authors.affiliation: Psychiatric Services Aargau AG, P.O. Box 432, 5201, Brugg, Switzerland.
authors.forename: Niklaus
authors.initials: N
authors.lastname: Stulz
authors.forename: Anja
authors.initials: A
authors.lastname: Nevely
authors.forename: Matthias
authors.initials: M
authors.lastname: Hilpert
authors.forename: Daniel
authors.initials: D
authors.lastname: Bielinski
authors.forename: Caesar
authors.initials: C
authors.lastname: Spisla
authors.forename: Lienhard
authors.initials: L
authors.lastname: Maeck
authors.forename: Urs
authors.initials: U
authors.lastname: Hepp
mesh_terms: D000553:Ambulatory Care / Q000191:economics / Q000706:statistics & numerical data*; D000066491:Clinical Decision-Making; D003362:Cost-Benefit Analysis; D016208:Databases, Factual; D003631:Day Care, Medical / Q000191:economics / Q000706:statistics & numerical data*; D004630:Emergencies; D017048:Health Care Costs; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data*; D006778:Hospitals, Psychiatric; D006801:Humans; D001523:Mental Disorders / Q000628:therapy*; D020380:Needs Assessment; D012017:Referral and Consultation