Medical psychiatric units are hospital inpatient wards aimed at patients with physical and mental disorders, a combination that is common, especially in hospitals. For clinically admitted hospital patients, mental illness is associated with a longer length of hospital stay (LOS), higher medical costs and more readmissions. MPUs focus on the one hand on facilitating medical treatment, and on the other hand on restoration of functioning and quality of life. It is also often emphasized that they have the potential to reduce length of stay, costs and readmissions. Medical and psychiatric diagnoses of patients in these wards are wide and varying. Providing acute medical care creates a field of tension with more process-oriented treatment. There are approxim

Schijndel, M.A. (Maarten) van

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van Schijndel, Maarten

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Medical psychiatry units: Improving their organization, focus, and value

Medical psychiatric units are hospital inpatient wards aimed at patients with physical and mental disorders, a combination that is common, especially in hospitals. For clinically admitted hospital patients, mental illness is associated with a longer length of hospital stay (LOS), higher medical costs and more readmissions. MPUs focus on the one hand on facilitating medical treatment, and on the other hand on restoration of functioning and quality of life. It is also often emphasized that they have the potential to reduce length of stay, costs and readmissions. Medical and psychiatric diagnoses of patients in these wards are wide and varying. Providing acute medical care creates a field of tension with more process-oriented treatment. There are approximately 40 MPUs in the Netherlands, largely located in psychiatric wards. The majority of these departments can treat patients with an average to high level of care. In the Netherlands, quality indicators for this care were proposed in 2014 and expanded in this thesis. The dissertation further investigates which factors influence the decision to admit patients to an MPU. Finally, it maps the target group of a new MPU to be established in an academic setting. In the future, MPUs should target even more people with severe psychiatric illness, who are known for their poor medical outcomes. This dissertation forms a basis to optimize the organization of MPUs by linking aims to structure and process characteristics. In the future, the different types of MPUs may facilitate outcome research

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1.  Psychiatric morbidity in hospital inpatients is associated with longer lengths of stay, higher medical costs, and more rehospitalizations. [dit proefschrift]2.  Medical psychiatry units improve patient outcomes and reduce costs.  [dit proefschrift]3.  Standardization of medical psychiatry unit designs is necessary to advance  the evidence base on their costs and effects. [dit proefschrift]4.  For setting admission criteria for medical psychiatry units, the competence level of the available nurses is more relevant than that of the available doctors. [dit proefschrift]5.  Present research into medical psychiatry units does not inform their  appropriate organization as it fails to link aims, design, and outcomes.  [dit proefschrift]6.  The distribution of resources during the coronavirus  crisis is based on illness  acuity rather than on costs and effects.7.  Quality documents and indicators are dictated by the interests of stakeholders.8.  Network care is an ineffective solution for the problems caused by healthcare fragmentation.9.  The case for integrated care for mental and physical health is as much about equal opportunities as it is about economic opportunities.10.  A meat tax is an excellent instrument to promote health and offers a quick  way out of the nitrogen crisis.11.  In terms of return on investment, the Netherlands should invest in Italy’s  economic preservation rather than in the preservation of the Royal Dutch  Airlines.MEDICAL PSYCHIATRY UNITSImproving their organization, focus, and valueStellingen behorend bij het proefschrift van Maarten A. van SchijndelMvS Proefschrift stellingen.indd   1 24-09-2020   09:34

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Medical psychiatry units: Improving their organization, focus, and value

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