Patterns of care in patients discharged from acute psychiatric inpatient facilities

Antonio Preti, Paola Rucci, Antonella Gigantesco, Giovanni Santone, Angelo Picardi, Rossella Miglio, Giovanni de Girolamo, F. Amaddeo, A. Barbato, G. Borgherini, G. Borsetti, R. Bracco, R. Canosa, M. Casacchia, I. Casula, P. Ciliberti, A. Colotto, A. D'Aloise, G. de Girolamo, G. Dell'AcquaM. De Palma, W. Di Munzio, A. Gaddini, G. Grassi, N. Longhin, M. Miceli, R. Miglio D Stat, P. Morosini, M. Nicotera, M. Percudani, B. Norcio, A. Picardi, R. Potzolu, E. Rossi, P. Rucci D Stat, G. Santone, S. Schiaffino, F. Scotti, R. Tomasi, G. Turrini, E. Zanalda, G. Agostani, F. Basile, F. Basilico, N. Battino, L. Bavero, G. Bazzacco, L. Biscaglia, R. Borio, S. Buttacavoli, B. Caporali, F. Cappelletti OT, L. Caserta, L. Cifarelli, P. Congia, M. Dazzi, L. Elia, E. Fantini, A. Galli, R. Gangi, A. Ghirardo, L. Giordano, S. Goldoni, A. Guidoni, S. Marchegiani, G. Morelli, M. Nassisi, E. Paltrinieri, K. Pesaresi, A. Pettolino, L. Pinciaroli, G. Pitzalis, M. Severini, C. Sighinolfi, G. Spinetti, A. Trequattrini, U. Unterfrauner, K. Wolf, L. Zecca

Research output: Contribution to journalArticle

Abstract

Objective: To analyze the characteristics of patients scheduled for discharge from acute psychiatric inpatient facilities in Italy, and their pattern of care. Methods: Socio-demographic and clinical characteristics, and patterns of care of 1,330 patients discharged from public and private inpatient facilities in Italy were assessed with a standardized methodology during an index period in the year 2004. Results: About one half of the samplehad schizophrenia or bipolar disorder. However, the case-mix differed between public and private facilities, where in-patients had more frequently mood and anxiety disorders. The use of two or more drugs was very common, involving more than 90% of patients and including typically benzodiazepines and antipsychotics. Structured psychosocial treatments were rarely initiated during the hospital stay. Increasing age, male gender, long stay in the facility (>60 days), personality disorder and type of facility were associated with a higher likelihood of being discharged to a community residential facility. Predictors of discharge to another psychiatric facility were increasing age, being single, schizophrenia, personality disorder and organic mental disorder. Families were not involved in decisions about patients' discharge in a significant proportion of cases. University psychiatric clinics and private facilities were less coordinated with the community system of care than General Hospital Psychiatric Units. Referral of patients with substance use disorder to drug addiction services occurred in just 30% of subjects. Conclusions: This study provides information on the characteristics and the pattern of care of patients discharged from inpatient facilities in a country that has closed down all its mental hospitals. This information may be relevant for those countries that are affording now the downsizing of MHs, and the expansion of community-based models of care.

Original languageEnglish
Pages (from-to)767-776
Number of pages10
JournalSocial Psychiatry and Psychiatric Epidemiology
Volume44
Issue number9
DOIs
Publication statusPublished - 2009

Keywords

  • General Hospital Psychiatric Units
  • Health services research
  • Mental disorders/epidemiology
  • Patterns of care

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Epidemiology
  • Health(social science)
  • Social Psychology

Fingerprint Dive into the research topics of 'Patterns of care in patients discharged from acute psychiatric inpatient facilities'. Together they form a unique fingerprint.

  • Cite this

    Preti, A., Rucci, P., Gigantesco, A., Santone, G., Picardi, A., Miglio, R., de Girolamo, G., Amaddeo, F., Barbato, A., Borgherini, G., Borsetti, G., Bracco, R., Canosa, R., Casacchia, M., Casula, I., Ciliberti, P., Colotto, A., D'Aloise, A., de Girolamo, G., ... Zecca, L. (2009). Patterns of care in patients discharged from acute psychiatric inpatient facilities. Social Psychiatry and Psychiatric Epidemiology, 44(9), 767-776. https://doi.org/10.1007/s00127-009-0498-2