[Pathways of psychiatric in-patients]

Abstract

Objective: Pathways of psychiatric in-patients before and after their hospital stay should be evaluated.

Method: Based on data of the psychiatric basic documentation of 4066 patients, predictors of type of referral as well as outpatient aftercare were analysed by means of logistic regression.

Result: 42.5 % of patients were admitted without any medical sending, 18.4 % by a general practitioner, and 9.8 % by a psychiatrist in private practice. Patients referred by a general practitioner suffered more frequently from affective disorders (Odds Ratio = 4.0) or schizophrenia (OR = 3.3), and were residents of a senior citizen home (OR = 3.5). Inpatients sent by a psychiatrist were more often residents of a sheltered home (OR = 2.8), had a present episode lasting more than three months (OR = 1.9) and psychopharmacological pre-treatment with atypical antipsychotics (OR = 1.6) or SSRI (OR = 1.8). Outpatient aftercare was recommended to 83.1 % of in-patients: Aftercare by a general practitioner was more frequent in patients with addiction disorders (OR = 2.0) and elderly patients (OR = 1.03). Referral by a psychiatrist in private practice (OR = 4.5) as well as schizophrenia (OR = 3.3) or affective disorders (OR = 2.4) led more often to an outpatient aftercare by a psychiatrist.

Conclusions: Beside therapeutic requirements the referring person predicted the type of outpatient aftercare.