Hostname: page-component-8448b6f56d-mp689 Total loading time: 0 Render date: 2024-04-23T20:18:41.669Z Has data issue: false hasContentIssue false
  • English
  • Français

Prediction of in-patient use in first-admitted patients with psychosis

Published online by Cambridge University Press:  16 April 2020

Barbara Lay ,
Christoph Lauber  and
Wulf Rössler
Barbara Lay*
Affiliation:
Psychiatric University Hospital Zurich, Research Unit for Clinical and Social Psychiatry, Militärstrasse 8, PO Box 1930, 8021Zurich, Switzerland
Christoph Lauber
Affiliation:
Psychiatric University Hospital Zurich, Research Unit for Clinical and Social Psychiatry, Militärstrasse 8, PO Box 1930, 8021Zurich, Switzerland
Wulf Rössler
Affiliation:
Psychiatric University Hospital Zurich, Research Unit for Clinical and Social Psychiatry, Militärstrasse 8, PO Box 1930, 8021Zurich, Switzerland
*
*Corresponding author. E-mail address: barbara.lay@bli.unizh.ch (B. Lay).
Get access

Abstract

Purpose:

The aim of this study is to examine the utilization of psychiatric services for inpatients with psychosis over a period of five years after first admission, and to identify factors that contribute to intensive service use in terms of cumulative length of in-patient treatment and readmission rate.

Methods:

A cohort of 424 patients with psychotic disorders (out of a sample of 2565 first-admitted patients from a catchment area in Switzerland) was examined by means of register data.

Results:

Patients admitted for psychosis spent the longest time in hospital compared to other diagnoses, but there was considerable within-sample variation, and most patients (60.4%) had only one in-patient episode. Of the total time accumulated in this sample, 50.5% was ‘consumed’ by 10.7% of patients. Regarding the overlap between ‘heavy use’ and ‘frequent use’ (those 10% of the sample with the longest/ most frequent hospitalizations), only 39.5% of the ‘frequent users’ were also ‘heavy users’ (vice versa: 38.6%). ‘Clinical’ measures were the main predictors of the overall time spent as an in-patient (schizophrenia diagnosis, therapeutic measures, clinical improvement). Concerning ‘heavy use’, homelessness was yet another important risk factor. Sociodemographic variables (age, level of education, living alone) particularly influenced the number of hospitalizations. A younger age at first admission was predictive of ‘heavy’ and ‘frequent’ use.

Discussion:

Clinical and sociodemographic factors explain differences in in-patient service consumption among patients with psychosis. Efforts to devise effective interventions have to take both into account, but different measures are needed to address ‘heavy’ and ‘frequent’ use.

Keywords

Psychotic disordersPsychiatric hospitalizationLength of stayPatient readmission
Type
Original article
Information
European Psychiatry , Volume 21 , Issue 6 , September 2006 , pp. 401 - 409
Copyright
Copyright © Elsevier SAS 2006

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Andrews, G., Hall, W., Goldstein, G., Lapsley, H., Bartels, R., Silove, D.The economic costs of schizophrenia. Implications for public policy Arch. Gen. Psychiatry 42(6)1985 537–543.CrossRefGoogle ScholarPubMed
Andrews, G., Issakidis, C., Sanderson, K., Corry, J., Lapsley, H.Utilising survey data to inform public policy: comparison of the cost-effectiveness of treatment of ten mental disorders Br. J. Psychiatry 2004; 184:526–533.CrossRefGoogle ScholarPubMed
Brenner, H.D., Hoffmann, H.Hospital beds are expensive for Swiss patients Psychiatr. Prax. 31(3)2004 166–168.Google ScholarPubMed
Christen S. Research Reports of the Psychiatric University Hospital Zürich. PSYREC Bericht 2002: ambulante und teilstationäre Behandlungen psychiatrischer Institutionen des Kantons Zürich. Vol. 8 No. 5. 2003. Psychiatrische Universitätsklinik Zürich.Google Scholar
Christen, S., Christen, L., Meyer, P.C., Eichenberger, A.Length of inpatient stay in psychiatric hospitals - Record Linkage. Psychiatric University Hospital of Zurich Research Report 8(1) Zürich: Psychiatrische Universitätsklinik; 2003.Google Scholar
Collegium-Internationale-Psychiatriae-Scalarum. Internationale Skalen fuer Psychiatrie <International scales for psychiatry>. 4., ueberarb. u. erw. Aufl. ed. Goettingen: Beltz Test, 1996..+4.,+ueberarb.+u.+erw.+Aufl.+ed.+Goettingen:+Beltz+Test,+1996.>Google Scholar
Dhossche, D.M., Ghani, S.O.A study on recidivism in the psychiatric emergency room Ann. Clin. Psychiatry 10(2)1998 59–67.CrossRefGoogle Scholar
Folsom, D.P., Hawthorne, W., Lindamer, L., Gilmer, T., Bailey, A., Golshan, S.et al.Prevalence and risk factors for homelessness and utilization of mental health services among 10,340 patients with serious mental illness in a large public mental health system Am. J. Psychiatry 162(2)2005 370–376.CrossRefGoogle Scholar
Frick, U., Rehm, J., Krischker, S., Cording, C.Comparative hospital tours: visiting the oasis of psychiatry Gesundheitswesen 63(7)2001 435–439.CrossRefGoogle ScholarPubMed
Harrow, M., Sands, J.R., Silverstein, M.L., Goldberg, J.F.Course and outcome for schizophrenia versus other psychotic patients: a longitudinal study Schizophr. Bull. 23(2)1997 287–303.CrossRefGoogle ScholarPubMed
Havassy, B.E., Hopkin, J.T.Factors predicting utilization of acute psychiatric inpatient services by frequently hospitalized patients Hosp. Community Psychiatry 40(8)1989 820–823.Google ScholarPubMed
Jaro, M.A.Probabilistic linkage of large public health data files Stat Med 14(5–7)1995 491–498.CrossRefGoogle ScholarPubMed
Junghan, U.M., Brenner, H.D.Heavy use of acute in-patient psychiatric services: The challenge to translate a utilization pattern into service provision Acta Psychiatr Scand; 2005.Google Scholar
Kent, S., Fogarty, M., Yellowlees, P.A review of studies of heavy users of psychiatric services Psychiatr. Serv. 46(12)1995 1247–1253.Google ScholarPubMed
Kent, S., Fogarty, M., Yellowlees, P.Heavy utilization of inpatient and outpatient services in a public mental health service Psychiatr. Serv. 46(12)1995 1254–1257.Google Scholar
Klinkenberg, W.D., Calsyn, R.J.Predictors of receipt of aftercare and recidivism among persons with severe mental illness: a review Psychiatr. Serv. 47(5)1996 487–496.Google ScholarPubMed
Krautgartner, M., Scherer, M., Katschnig, H.Days in psychiatric hospitals: who consumes most of them? A five-year record linkage study of "Heavy Users" in an Austrian province Psychiatr. Prax. 29(7)2002 355–363.CrossRefGoogle Scholar
Lauber, C., Lay, B., Rossler, W.Homelessness among people with severe mental illness in Switzerland Swiss Med. Wkly. 135(3–4)2005 50–56.Google ScholarPubMed
Lehman, A.F., Steinwachs, D.M.Patterns of usual care for schizophrenia: initial results from the Schizophrenia Patient Outcomes Research Team (PORT) Client Survey Schizophr. Bull. 24(1)1998 11–20.CrossRefGoogle ScholarPubMed
Lehman, A.F., Steinwachs, D.M.Evidence-based psychosocial treatment practices in schizophrenia: lessons from the patient outcomes research team (PORT) project J Am Acad Psychoanal Dyn Psychiatry 31(1)2003 141–154.CrossRefGoogle ScholarPubMed
Martin, B.C., Miller, L.S.Expenditures for treating schizophrenia: a population-based study of Georgia Medicaid recipients Schizophr. Bull. 24(3)1998 479–488.CrossRefGoogle ScholarPubMed
Miller, L.S., Martin, B.C.Current and future forecasts of service use and expenditures of Medicaid-eligible schizophrenia patients in the state of Georgia Schizophr. Bull. 30(4)2004 983–995.CrossRefGoogle ScholarPubMed
Montgomery, P., Kirkpatrick, H.Understanding those who seek frequent psychiatric hospitalizations Arch. Psychiatr. Nurs. 16(1)2002 16–24.CrossRefGoogle ScholarPubMed
Mortensen, P.B., Eaton, W.W.Predictors for readmission risk in schizophrenia Psychol. Med. 24(1)1994 223–232.CrossRefGoogle Scholar
Rabinowitz, J., Mark, M., Popper, M., Slyuzberg, M., Munitz, H.Predicting revolving-door patients in a 9-year national sample Soc. Psychiatry Psychiatr. Epidemiol. 30(2)1995 65–72.CrossRefGoogle Scholar
Richter, D.[Psychiatric inpatient length of stay. An overview of methods, influences and consequences] Fortschr. Neurol. Psychiatr. 69(1)2001 19–31.CrossRefGoogle Scholar
Roick, C., Gartner, A., Heider, D., Angermeyer, M.C.[Heavy users of psychiatric care] Psychiatr. Prax. 29(7)2002 334–342.CrossRefGoogle Scholar
Roick, C., Heider, D., Kilian, R., Matschinger, H., Toumi, M., Angermeyer, M.C.Factors contributing to frequent use of psychiatric inpatient services by schizophrenia patients Soc. Psychiatry Psychiatr. Epidemiol. 39(9)2004 744–751.CrossRefGoogle ScholarPubMed
Saarento, O., Hakko, H., Joukamaa, M.Repeated use of psychiatric emergency out-patient services among new patients: a 3-year follow-up study Acta Psychiatr. Scand. 98(4)1998 276–282.CrossRefGoogle ScholarPubMed
Spiessl, H., Hubner-Liebermann, B., Binder, H., Cording, C.[Heavy users in a psychiatric hospital--a cohort study on 1811 patients over five years] Psychiatr. Prax. 29(7)2002 350–354.Google Scholar
SPSS for Windows V115 Chicago Illinois: SPSS Inc.; 2002.Google Scholar
Steinhart, I., Priebe, S.Prediction of hospitalization within a psychiatric community care system--a five-year study Soc. Psychiatry Psychiatr. Epidemiol. 27(6)1992 270–273.Google ScholarPubMed
Swiss Medical Association. 6. Berufstätige Ärzte nach Kanton und Fachgebiet. http://www.fmh.ch/fr/data/pdf/sts2002-06.pdf. 5-10-2004. 2005.Google Scholar
Tansella, M., Micciolo, R., Biggeri, A., Bisoffi, G., Balestrieri, M.Episodes of care for first-ever psychiatric patients. A long-term case-register evaluation in a mainly urban area Br. J. Psychiatry 167(2)1995 220–227.CrossRefGoogle Scholar
Validity Technology Inc. The Integrity Data Re-engeneering Environment - SuperMATCH advanced guide, Version 3.5 Validity Technology Inc.; 1999.Google Scholar
Woogh, C.M.A cohort through the revolving door Can. J. Psychiatry 31(3)1986 214–221.CrossRefGoogle ScholarPubMed
World Health Organisation. The International Statistical Classification of Diseases and Related Health Problems, 10th revision. Chapter V (F). German Version Bern: Huber; 1993.Google Scholar
Submit a response

Comments

No Comments have been published for this article.