[The psychiatrist and the psychiatric hospital--an analysis of referral and aftercare]

Abstract

Objective: Against the background of the problematic interface between outpatient and inpatient care in the German psychiatric health care system, the role of psychiatrists in private practice concerning the pathways of psychiatric inpatients before and after their hospital stay should be evaluated.

Methods: Based on data of the psychiatric basic documentation (DGPPN-BADO) of 4905 patients admitted to the psychiatric hospital in 2003, predictors of the type of referral as well as the outpatient aftercare were analysed by means of logistic regression analyses.

Results: 9.8 % of patients were referred by psychiatrists in private practice. Patients sent by psychiatrists more seldom had an addiction disorder, more often were residents of sheltered homes, showed a present episode lasting more than three months and had a psychopharmacological pre-treatment with an atypical antipsychotic or SSRI. At discharge, outpatient aftercare by psychiatrists in private practice was recommended to 32.1 % of inpatients. Referral by a psychiatrist in private practice as well as the diagnosis of schizophrenia or affective disorder led more often to an outpatient aftercare by a psychiatrist.

Conclusions: Due to the small number of patients referred by psychiatrists, the cooperation between psychiatric hospital and psychiatrists in private practice has to be focused by the quality management of the hospital.