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Alternatives to psychiatric in-patient care: A case-by-case survey of clinician judgements
Acute psychiatric beds in the UK are under pressure. More beds are often called for, yet conceivably many in-patients might benefit from alternative care-settings. We studied an admissions cohort of 730 cases in four hospitals over a 5-month period. Using a structured instrument, Consultant Psychiat...
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Published in: | Journal of mental health (Abingdon, England) England), 2001, Vol.10 (5), p.535-546 |
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container_end_page | 546 |
container_issue | 5 |
container_start_page | 535 |
container_title | Journal of mental health (Abingdon, England) |
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creator | Bartlett, John Holloway, Mark Evans, John Owen, Glynn Harrison, Christopher |
description | Acute psychiatric beds in the UK are under pressure. More beds are often called for, yet conceivably many in-patients might benefit from alternative care-settings. We studied an admissions cohort of 730 cases in four hospitals over a 5-month period. Using a structured instrument, Consultant Psychiatrists recorded an opinion, on a case-by-case basis, stating whether admission was divertible or whether discharge was delayed, recommending alternative placements where applicable. One hundred and seventy-nine of 543 cases with stays completed in the study period were deemed inappropriately placed at some point (33.0%, 95% CI 29.0 to 36.9), with 112 (21%) being divertible admissions. When surveyed systematically, clinicians reported that many in-patients could benefit from alternative caresettings, the majority being community-based services, although more specialised hospital beds were also needed. Divertible admissions are judged to impose more pressure on acute beds than delayed discharges, although a small number of difficult-to-place patients with protracted stays can occupy many bed-days. |
doi_str_mv | 10.1080/09638230126726 |
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More beds are often called for, yet conceivably many in-patients might benefit from alternative care-settings. We studied an admissions cohort of 730 cases in four hospitals over a 5-month period. Using a structured instrument, Consultant Psychiatrists recorded an opinion, on a case-by-case basis, stating whether admission was divertible or whether discharge was delayed, recommending alternative placements where applicable. One hundred and seventy-nine of 543 cases with stays completed in the study period were deemed inappropriately placed at some point (33.0%, 95% CI 29.0 to 36.9), with 112 (21%) being divertible admissions. When surveyed systematically, clinicians reported that many in-patients could benefit from alternative caresettings, the majority being community-based services, although more specialised hospital beds were also needed. 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More beds are often called for, yet conceivably many in-patients might benefit from alternative care-settings. We studied an admissions cohort of 730 cases in four hospitals over a 5-month period. Using a structured instrument, Consultant Psychiatrists recorded an opinion, on a case-by-case basis, stating whether admission was divertible or whether discharge was delayed, recommending alternative placements where applicable. One hundred and seventy-nine of 543 cases with stays completed in the study period were deemed inappropriately placed at some point (33.0%, 95% CI 29.0 to 36.9), with 112 (21%) being divertible admissions. When surveyed systematically, clinicians reported that many in-patients could benefit from alternative caresettings, the majority being community-based services, although more specialised hospital beds were also needed. Divertible admissions are judged to impose more pressure on acute beds than delayed discharges, although a small number of difficult-to-place patients with protracted stays can occupy many bed-days.</description><subject>Admissions</subject><subject>Alternatives</subject><subject>Biological and medical sciences</subject><subject>England</subject><subject>Inpatient care</subject><subject>Institution therapy. Inpatient treatment</subject><subject>Judgments</subject><subject>Medical sciences</subject><subject>Mental health care</subject><subject>Patient admissions</subject><subject>Patients</subject><subject>Psychiatric hospitals</subject><subject>Psychiatrists</subject><subject>Psychology. Psychoanalysis. Psychiatry</subject><subject>Psychopathology. 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Inpatient treatment</topic><topic>Judgments</topic><topic>Medical sciences</topic><topic>Mental health care</topic><topic>Patient admissions</topic><topic>Patients</topic><topic>Psychiatric hospitals</topic><topic>Psychiatrists</topic><topic>Psychology. Psychoanalysis. Psychiatry</topic><topic>Psychopathology. 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ispartof | Journal of mental health (Abingdon, England), 2001, Vol.10 (5), p.535-546 |
issn | 0963-8237 1360-0567 |
language | eng |
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source | Applied Social Sciences Index & Abstracts (ASSIA); Taylor & Francis |
subjects | Admissions Alternatives Biological and medical sciences England Inpatient care Institution therapy. Inpatient treatment Judgments Medical sciences Mental health care Patient admissions Patients Psychiatric hospitals Psychiatrists Psychology. Psychoanalysis. Psychiatry Psychopathology. Psychiatry Treatments |
title | Alternatives to psychiatric in-patient care: A case-by-case survey of clinician judgements |
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