title: [Heavy users of inpatient services: a comparison of diagnostic subgroups].
abstract: OBJECTIVE
  Quantitative and qualitative assessment of heavy users (HU) of psychiatric inpatient treatment.
  
  
  METHODS
  Screening over 9 months for patients with ≥ 3 admissions or ≥ 100 days of treatment during 1 year prior to index admission.
  
  
  RESULTS
  During the recruiting period 1217 persons were treated of whom 132 (10.8 %) fulfilled HU criteria. Patients belonged most often to the diagnostic group F2 (43 %), followed by F1 (21 %) and F3 (17 %). HU were most common within the diagnostic group F6 (33 %), next to F2 (21 %), F1 (9 %) and F3 (6 %). HU had signs of more severe illness compared to the other patients: only 8 % held a job and 73 % ware on a disablement pension, patients with a diagnosis of F2 faring worst. HU were treated more frequently involuntarily (50.5 vs 30.7 %). An office-based physician referred only 5 % of the patients and almost half attended the clinic without any referral. HU participated only to a modest degree in community-based treatments and 37 % attended no doctor in the month prior to admission. During the year following the index admission more than 80 % of HU were admitted again and were hospitalized almost as many days as before the index admission. Patients with a diagnosis of F1 and F2 showed the greatest persistence of heavy use behavior.
  
  
  CONCLUSIONS
  This sample of HU show a persistent pattern of use of psychiatric inpatient treatment. Strategies to improve the situation are discussed.
authors: Psychiatrie 1, LNK Wagner-Jauregg, Wagner-Jauregg-Weg 15, 4020, Linz, Österreich, hans.rittmannsberger@gespag.at.
authors: Hans
authors: H
authors: Rittmannsberger
authors: Anke
authors: A
authors: Sulzbacher
authors: Christian
authors: C
authors: Foff
authors: Thomas
authors: T
authors: Zaunmüller
mesh_terms: D000328:Adult; D001317:Austria; D003953:Diagnosis-Related Groups / Q000706:statistics & numerical data; D005260:Female; D006300:Health Services Misuse / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis* / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy; D008875:Middle Aged; D010343:Patient Admission / Q000706:statistics & numerical data*; D010359:Patient Readmission / Q000706:statistics & numerical data; D011567:Psychiatric Department, Hospital / Q000706:statistics & numerical data*; D036301:Qualitative Research; D014600:Utilization Review / Q000706:statistics & numerical data; D055815:Young Adult