Local inpatient units may increase patients' utilization of outpatient services: a comparative cohort-study in Nordland County, Norway
Authors Myklebust L, Sørgaard K, Wynn R
Received 20 August 2015
Accepted for publication 22 September 2015
Published 28 October 2015 Volume 2015:8 Pages 251—257
Checked for plagiarism Yes
Review by Single-blind
Peer reviewer comments 3
Editor who approved publication: Professor Igor Elman
Lars Henrik Myklebust,1 Knut Sørgaard,1,2 Rolf Wynn2
1Psychiatric Research Centre of North Norway, Nordland Hospital Trust, Bodø, 2Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
Objectives: In the last few decades, there has been a restructuring of the psychiatric services in many countries. The complexity of these systems may represent a challenge to patients that suffer from serious psychiatric disorders. We examined whether local integration of inpatient and outpatient services in contrast to centralized institutions strengthened continuity of care.
Methods: Two different service-systems were compared. Service-utilization over a 4-year period for 690 inpatients was extracted from the patient registries. The results were controlled for demographic variables, model of service-system, central inpatient admission or local inpatient admission, diagnoses, and duration of inpatient stays.
Results: The majority of inpatients in the area with local integration of inpatient and outpatient services used both types of care. In the area that did not have beds locally, many patients that had been hospitalized did not receive outpatient follow-up. Predictors of inpatients' use of outpatient psychiatric care were: Model of service-system (centralized vs decentralized), a diagnosis of affective disorder, central inpatient admission only, and duration of inpatient stays.
Conclusion: Psychiatric centers with local inpatient units may positively affect continuity of care for patients with severe psychiatric disorders, probably because of a high functional integration of inpatient and outpatient care.
Keywords: psychiatry, hospitalization, decentralization, outpatients, continuity of care, health service research, affective
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