201 research outputs found
Exploring Continuity of Care in Patients with Alcohol Use Disorders Using Time-Variant Measures
Background/Aims: We used time-variant measures of continuity of care to study fluctuations in long-term treatment use by patients with alcohol-related disorders. Methods: Data on service use were extracted from the Psychiatric Case Register for the Rotterdam Region, The Netherlands. Continuity measures were calculated for each day over a 2-year observation period. Repeated measures analysis was used to identify factors that influence continuity of care over time. Results: Continuity of care was higher for patients with more severe disorders. Though quantity of care was high for patients with long problem history during the first year of treatment, it decreased strongly in the second year. The intervals between treatment contacts were shorter for women, especially young ones, than for men. Conclusion: Time-variant measures showed differences in continuity of care that would not have been revealed if more aggregated measures of service use had been used. Copyright (C) 2008 S. Karger AG, Base
Does mental health service integration affect compulsory admissions?
Background: Over recent years, the number of compulsory admissions in many countries has increased, probably as a result of the shift from inpatient to outpatient mental health care. This might be mitigated by formal or collaborative relationships between services. <br><br> Methods: In a retrospective record linkage study, we compared two neighboring districts, varying in level of service integration. Two periods were combined: 1991–1993 and 2001–2003. We included patients aged 18–60, who had a first emergency compulsory admission (n=830). Their psychiatric history was assessed, and service-use after admission was monitored over a 12-month follow-up. <br><br> Results: Over a 10-year period, compulsory admission rates increased by 47%. Difference in relative increase between the integrated and non-integrated services was 14%. Patient characteristics showed different profiles in the two districts. Length of stay was >10 days shorter in the integrated district, where the proportion of involuntary readmissions decreased more, and where aftercare was swift and provided to about 10% more patients than in the non-integrated district. <br><br> Conclusions: Services outcomes showed better results where mental healthcare was more integrated. However, limited effects were found and other factors than integration of services may be more important in preventing compulsory admissions
Does mental health service integration affect compulsory admissions?
Abstract.
BACKGROUND: Over recent years, the number of compulsory admissions in many countries has increased, probably as a result of the shift from inpatient to outpatient mental health care. This might be mitigated by formal or collaborative relationships between services.
METHODS: In a retrospective record linkage study, we compared two neighboring districts, varying in level of service integration. Two periods were combined: 1991-1993 and 2001-2003. We included patients aged 18-60, who had a first emergency compulsory admission (n=830). Their psychiatric history was assessed, and service-use after admission was monitored over a 12-month follow-up.
RESULTS: Over a 10-year period, compulsory admission rates increased by 47%. Difference in relative increase between the integrated and non-integrated services was 14%. Patient characteristics showed different profiles in the two districts. Length of stay was >10 days shorter in the integrated district, where the proportion of involuntary readmissions decreased more, and where aftercare was swift and provided to about 10% more patients than in the non-integrated district.
CONCLUSIONS: Services outcomes showed better results where mental healthcare was more integrated. However, limited effects were found and other factors than integration of services may be more important in preventing compulsory admissions
Cost sharing does not lead to an overall increase of involuntary commitments in the Netherlands
Exploring Continuity of Care in Patients with Alcohol Use Disorders Using Time-Variant Measures
Background/Aims: We used time-variant measures of continuity
of care to study fluctuations in long-term treatment
use by patients with alcohol-related disorders. Methods:
Data on service use were extracted from the Psychiatric Case
Register for the Rotterdam Region, The Netherlands. Continuity
measures were calculated for each day over a 2-year
observation period. Repeated measures analysis was used to
identify factors that influence continuity of care over time.
Results: Continuity of care was higher for patients with more
severe disorders. Though quantity of care was high for patients
with long problem history during the first year of
treatment, it decreased strongly in the second year. The intervals
between treatment contacts were shorter for women,
especially young ones, than for men. Conclusion: Timevariant
measures showed differences in continuity of care
that would not have been revealed if more aggregated measures
of service use had been used
Follow-up after Involuntary Mental Healthcare: Who Cares? Emergency Compulsory Admission and Continuity of Care in Rotterdam, the Netherlands
In 2000 Dutch television broadcasted a documentary, filmed by Hans
Polak, about people who neglect themselves and their social environment.
The film shows public mental health workers visiting people who fall outside
of the regular healthcare system. These people live on the frayed
fringes of society, such as a man from a wealthy family who lives in a
faeces-stained apartment, an old organ-grinder sharing living and working
space with a heroin prostitute, a mentally disordered woman who
keeps hundreds of mice as pets, an old and lonely opera singer who
rarely leaves home, and an addicted couple who have lost parental rights.
This opening chapter follows up on the case of the (formerly) addicted
couple – names have been omitted to ensure privacy; the couple has
given written permission to publish their story. Our study showed that in
the period 2000 – 2006 no fewer than 81 social workers or nurses, spread
over about 25 health and social services, have been involved in the case
An intensive multimodal group programme for patients with psychotic disorders at risk of rehospitalization: a controlled intervention study
Breakdown of continuity in public mental healthcare in the Netherlands: a longitudinal case study
<strong>Introduction:</strong> Continuity of care for long-term service-dependent patients in the public mental health system requires intensive collaboration between all agencies involved. Understanding the ways in which various aspects of continuity of care interact may reveal help to find out more about how care deÂlivered over time improves outcomes. <strong>C</strong><strong>ase study:</strong> Based on medical records, an addicted couple was monitored for number and type of contacts with health and social services. Over the years, 81 social workers or nurses, spread over 25 health and social services, have been involved in the rehabilitation process. Breakdown of continuity of care is linked to lack of information, missing procedures and guidelines, fragile relationships with the patient, and a reluctant public health approach. <strong>Conclu</strong><strong>sion: </strong>Prominent among relevant factors is the absence of protocols governing the transfer of patients between the various links in the continuum of mental healthcare services. High-quality follow-up after admission is partly a matter of professional principle in ensuring that problems in the chain of services are discussed. Case presenÂtation in psychiatric journals should give systeÂmatic atÂtenÂtion to sources of error in continuity of mental healthÂcare
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