Markers of inappropriate placement in acute psychiatric impatient care : a five hospital study.
Previous researchers in the UK have measured the prevalence of the inappropriateness'of acute adult psychiatric inpatient placements by eliciting the judgements of health professionals.
We extended the methodology by identifying inpatient sub-groups with stable characteristics that were associated with elevated risk of inappropriate placement, and by calculating the level of that risk.
A 1-day census was taken in five hospitals.
Using a structured instrument, consultant psychiatrists recorded judgements on current placements, recommended alternative placements and stated why alternatives had not beer used.
Judgements were obtained for 100% of the 261 inpatients.
Risk ratios and adjusted odds ratios were calculated to identify sub-groups that were at high risk.
Eighty-eight inpatients were inappropriately placed, a point prevalence of 34% (95% CI 28-40%). Consultants recorded that services outside hospital, if available, could have supported most of these inpatients as an alternative to at least part of their hospital stay.
Diagnostic rather than socio-demographic or administrative characteristics, in particular primary diagnoses of substance-related disorder, personality disorder, anxiety/stress, and schizophrenia with co-morbid substance misuse, were the strongest markers of elevated risk.
The point prevalence of inappropriate placement within the British mental health-care system is considerable. (...)
Mots-clés Pascal : Hospitalisation, Hôpital psychiatrique, Critère, Etude critique, Système santé, Qualité service, Service santé, Santé mentale, Royaume Uni, Europe, Homme
Mots-clés Pascal anglais : Hospitalization, Psychiatric hospital, Criterion, Critical study, Health system, Service quality, Health service, Mental health, United Kingdom, Europe, Human
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0399336
Code Inist : 002B18H05B. Création : 22/03/2000.