The scheduled appointment system, widely used in most mental health services, has never been evaluated.
This study attempts such an evaluation within a community-based mental health service that permits unplanned access to specialist care, by comparing further service use of first-episode patients who come unannounced to seek psychiatric care with that of patients with a planned (scheduled) initial appointment.
All patients with first lifetime psychiatric contact who contacted psychiatric services reporting to the South-Verona Psychiatric Case Register between 1 January 1982 and 31 December 1989 (n=1261) were identified.
A total of 1056 patients entered the study and were followed for 2 years.
Poisson regression with the generalised estimating equation (GEE) method (to take into account both overdispersion of contacts between subjects and correlation between contacts within subjects) was used to evaluate the effects of the type of first-ever contact (defined as planned or unplanned according to whether or not a regular appointment was previously arranged) and of other selected variables, including sociodemographic characteristics, on the annual rate of planned and unplanned care in the follow-up period.
Thirty-six percent of first-ever contacts were unplanned.
Patients who began with unplanned contact, as compared with others, were more often widowed, separated or divorced, unemployed and with a diagnosis of schizophrenia or organic psychosis. (...)
Mots-clés Pascal : Prédiction, Evolution, Utilisation, Service santé, Santé mentale, Trouble psychiatrique, Homme
Mots-clés Pascal anglais : Prediction, Evolution, Use, Health service, Mental health, Mental disorder, Human
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0203463
Code Inist : 002B18H05B. Création : 11/09/1998.