Journal articles on the topic 'Psychiatric hospital care South Australia'
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1
Cammell, Paul. "Emergency psychiatry: a product of circumstance or a growing sub-speciality field?" Australasian Psychiatry 25, no. 1 (September 26, 2016): 53–55. http://dx.doi.org/10.1177/1039856216665286.
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Objectives: This article reviews recent trends in the provision of psychiatric services to the emergency departments of tertiary hospitals in Australia, involving the establishment of specialised in-reach or liaison services as well as various forms of short stay unit attached to emergency departments. The Emergency Psychiatry Service at Flinders Medical Centre, South Australia, is described as a case example. Its specialised models of assessment and clinical care are described, highlighting how these are differentiated from more traditional models in inpatient, community and general hospital consultation–liaison psychiatry. Conclusions: Emergency psychiatry, and in particular the application of specialised psychiatric models of in-reach service and short stay units, is an increasingly important and growing field of psychiatry that warrants further exploration in research. The Emergency Psychiatry Service at Flinders Medical Centre has developed a distinct group of assessment and treatment approaches that exemplifies this growing field.
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Boast, Neil. "Forensic psychiatry – a tale of two systems." Psychiatric Bulletin 14, no. 12 (December 1990): 722–24. http://dx.doi.org/10.1192/pb.14.12.722.
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During registrar training I had the privilege of working in the interim secure unit at Friern Hospital in London. To gain further experience in the field of forensic psychiatry, I secured (if that is an appropriate term), a post as trainee psychiatrist at James Nash House, centre for forensic psychiatry, Adelaide, South Australia. This article compares the legal and health care frameworks in England and South Australia relevant to mentally abnormal offenders. The two units are described and differences in facilities, patient populations and working practices are discussed.
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Patti, Charles H. "St. James Hospital: A Case in Crisis Management." Journal of Management & Organization 9, no. 2 (January 2003): 75–78. http://dx.doi.org/10.1017/s183336720000482x.
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This definitely was not the type of day that St. James Hospital CEO, Paul Ryan, was expecting. As the groundbreaking ceremonies for the Hospital's new addition were about to begin, Paul found himself facing an unsympathetic press and an angry group of protesters. Clearly, he had a crisis on his hands.St. James Hospital in Parramatta (Western Sydney area of New South Wales, Australia) is a 400-bed multi-specialty community hospital providing ambulatory care, acute care, and psychiatric care services to residents living within the five suburbs of Auburn, Holroyd, Parramatta, Blacktown, and Baulkhaum Hills in the area of Western Sydney. The population of this area is multi-cultural with nearly one-third of the population born overseas and thirty percent speaking a language other than English. The area's population also differs from the population of New South Wales in other demographic characteristics. Table 1 shows some of these differences, although the data do not always allow direct comparisons. These differences have presented the management and staff of St. James Hospital with special socio-cultural, financial, and communication challenges.
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Patti, Charles H. "St. James Hospital: A Case in Crisis Management." Journal of the Australian and New Zealand Academy of Management 9, no. 2 (January 2003): 75–78. http://dx.doi.org/10.5172/jmo.2003.9.2.75.
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This definitely was not the type of day that St. James Hospital CEO, Paul Ryan, was expecting. As the groundbreaking ceremonies for the Hospital's new addition were about to begin, Paul found himself facing an unsympathetic press and an angry group of protesters. Clearly, he had a crisis on his hands.St. James Hospital in Parramatta (Western Sydney area of New South Wales, Australia) is a 400-bed multi-specialty community hospital providing ambulatory care, acute care, and psychiatric care services to residents living within the five suburbs of Auburn, Holroyd, Parramatta, Blacktown, and Baulkhaum Hills in the area of Western Sydney. The population of this area is multi-cultural with nearly one-third of the population born overseas and thirty percent speaking a language other than English. The area's population also differs from the population of New South Wales in other demographic characteristics. Table 1 shows some of these differences, although the data do not always allow direct comparisons. These differences have presented the management and staff of St. James Hospital with special socio-cultural, financial, and communication challenges.
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Lupton, Deborah. "Back to Bedlam? Chelmsford and the Press." Australian & New Zealand Journal of Psychiatry 27, no. 1 (March 1993): 140–48. http://dx.doi.org/10.3109/00048679309072133.
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The Australian press played a vital part in bringing the events at Chelmsford Private Hospital to the attention of the general public, and in pressuring the New South Wales government to institute a Royal Commission into Deep Sleep Therapy. This paper describes the ways in which the press brought Chelmsford events onto the public agenda. It pays particular attention to aspects of the press coverage of the findings of the Royal Commission. The paper identifies the discourses concerning psychiatric care, the doctor-patient relationship and the role of the government in regulating the medical profession which were dominant in press accounts of Chelmsford. It is argued that while pre-existing stereotypes about mad psychiatrists and asylums were used to describe Chelmsford, more confronting ideas concerning the need for medical regulation and patient consumerism received press attention and therefore a public airing. The implications for psychiatric care in Australia are examined.
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Hazell, Philip, Titia Sprague, and Joanne Sharpe. "Psychiatric hospital treatment of children and adolescents in New South Wales, Australia: 12-year trends." BJPsych Open 2, no. 1 (January 2016): 1–5. http://dx.doi.org/10.1192/bjpo.bp.115.000794.
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BackgroundIt is preferable that children and adolescents requiring in-patient care for mental health problems are managed in age-appropriate facilities. To achieve this, nine specialist Child and Adolescent Mental Health Services (CAMHS) in-patient units have been commissioned in New South Wales (NSW) since 2002.AimsTo examine trends in child and adolescent in-patient admissions since the opening of these CAMHS units.MethodAnalysis of separation data for under 18-year-olds to CAMHS, adult mental health and paediatric units for the period 2002 to 2013 in NSW, comparing districts with and without specialist CAMHS units.ResultsSeparations from CAMHS, adult and paediatric units rose with time, but there was no interaction between time and health district type (with/without CAMHS unit). Five of eight health districts experienced increased separations of under 18-year-olds from adult units in the year of opening a CAMHS unit. Separations from related paediatric units increased in three of seven health districts.ConclusionsOpening CAMHS units may be followed by a temporary increase in separations of young people from adult units, but it does not influence the flow of patients to non-CAMHS facilities in the longer term.
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Bell, Maureen. "From the 1870s to the 1970s: the Changing Face of Public Psychiatry in South Australia." Australasian Psychiatry 11, no. 1 (March 2003): 79–86. http://dx.doi.org/10.1046/j.1440-1665.2003.00513.x.
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Objective: To give an overview of the development of psychiatric services in South Australia from the 1870s to the 1970s, to describe some of the milestones in their progress, and to demonstrate that many of the guiding principles of contemporary services can be found to have their roots in this period. Conclusions: Psychiatric services in South Australia progressed in fits and starts, but not for want of commitment and concern by those responsible for the care of the mentally ill. While in broad outline the development of services followed the course taken in other states, it is clear that the individual efforts of staff of the hospitals and a number of members of the public played an important role in improving the conditions and treatment of those with a mental illness, and laying the foundations for the movement of psychiatric services from their early isolationist position into the general health arena.
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Spittal, Matthew J., Fiona Shand, Helen Christensen, Lisa Brophy, and Jane Pirkis. "Community mental health care after self-harm: A retrospective cohort study." Australian & New Zealand Journal of Psychiatry 51, no. 7 (November 12, 2016): 727–35. http://dx.doi.org/10.1177/0004867416676366.
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Objective: Presentation to hospital after self-harm is an opportunity to treat underlying mental health problems. We aimed to describe the pattern of mental health contacts following hospital admission focusing on those with and without recent contact with community mental health services (connected and unconnected patients). Methods: We undertook a data linkage study of all individuals admitted as a general or psychiatric inpatient to hospital after self-harm in New South Wales, Australia, between 2005 and 2011. We identified the proportion of admissions where the patient received subsequent in-person community mental health care within 30 days of discharge and the factors associated with receipt of that care. Results: A total of 42,353 individuals were admitted to hospital for self-harm. In 41% of admissions, the patient had contact with a community mental health service after discharge. Patients connected with community mental health services had 5.33 (95% confidence interval = [5.09, 5.59]) times higher odds of follow-up care than unconnected patients. Other factors, such as increasing age and treatment as a psychiatric inpatient, were associated with lower odds of follow-up community care. Conclusion: Our study suggests that full advantage is not being taken of the opportunity to provide comprehensive mental health care for people who self-harm once they have been discharged from the inpatient setting. This is particularly the case for those who have not previously received community mental health care. There appears to be scope for system-level improvement in the way in which those who are treated for self-harm are followed up in the community.
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Hafner, R. J., J. Lammersma, R. Ferris, and M. Cameron. "The Use of Seclusion: A Comparison of Two Psychiatric Intensive Care Units." Australian & New Zealand Journal of Psychiatry 23, no. 2 (June 1989): 235–39. http://dx.doi.org/10.3109/00048678909062140.
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The use of seclusion within a psychiatric intensive care unit in a South Australian metropolitan mental hospital was documented over a ten week period. The seclusion rate within the unit was 32% of all admissions and 34% of new admissions. The overall seclusion rate for the hospital was 5.4% of all admissions and 6.3% of new admissions, somewhat higher than in the United Kingdom but considerably lower than in the Eastern United States. A comparison was then made between consecutive new admissions (30 secluded and 30 non-secluded) to this unit and to a similar unit without a seclusion room in the other mental hospital in the State. Although seclusion offered no clear advantages in terms of duration of admission, levels of medication or relapse rates, it appeared to reduce the level of dangerousness in the unit, thereby enhancing staff morale. The overall mean daily total of neuroleptic medication was about 1,200 mg chlorpromazine equivalent, somewhat less than in comparable units in the United States and Europe.
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Iyer, Reena, David Smith, and Sharon Lawn. "An audit of the management of nicotine withdrawal in an Australian inpatient unit: are we there yet?" Australasian Psychiatry 26, no. 1 (October 2, 2017): 13–19. http://dx.doi.org/10.1177/1039856217732481.
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Objectives: This paper reports outcomes of a clinical audit of smoke-free policy implementation within an Australian inpatient psychiatric setting. It aimed to evaluate assessment of smoking status and subsequent management of nicotine withdrawal, and investigate any patient factors influencing these processes. Methods: A total of 67 medical case notes were retrospectively analysed for inpatients admitted to psychiatric units of a general hospital in South Australia, from July to September 2015. Patient demographic variables and information from the hospital’s Smoking Assessment and Management Form (SAMF) were recorded. Data analysis involved descriptive statistics and Chi-square tests of association between dependent variables (how the SAMF was completed) and independent variables (sex, voluntary status, diagnosis). Results: The SAMF was implemented for most patients (76.1%), with 64.71% completed within 24 hours of admission; though, many were incomplete. Nicotine dependence was not properly assessed for 42.3% of smokers; 69.23% were prescribed nicotine replacement therapy (NRT), despite most scoring moderate to high nicotine dependence. No statistically significant relationships were found between patient factors and form completion. Conclusions: SAMF completion was timely for most patients; however, sections important for determining support actions remained largely incomplete, suggesting patients’ nicotine withdrawal is not being adequately addressed. More work is needed to improve inpatient staff’s assessment to ensure optimal care.
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Richardson, Michael Ernest. "Rooming-in: An Alternative to Involuntary Detention." Australian & New Zealand Journal of Psychiatry 30, no. 2 (April 1996): 263–69. http://dx.doi.org/10.3109/00048679609076104.
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Objective: To provide, via ‘rooming-in’, a local, less coercive and less frightening alternative to involuntary detention. Rooming In is the voluntary participation of so-called ‘confidants’, who may be chosen family members or trusted friends, in the management of acute, severe psychiatric disturbance by their providing a 24 hour vigil with the patient in a single, safe hospital room. Method: There were 73 admissions to the rooming-in program at the Manning Base Hospital, Taree, New South Wales (NSW), Australia between 5 August 1986 and 21 September 1992. During the same period 78 patients were remitted from the hospital on an involuntary basis to urban detention centres: ‘scheduled’ under the NSW Mental Health Act. Demographic and diagnostic characteristics of the two populations, both of whom met identical criteria for involuntary detention, are compared in this retrospective, case report study. These two groups constituted only 6% of total psychiatric consults carried out at the hospital over the same 6 year period and those roomed-in represented only 12% of the psychiatric admissions. A quality assurance study evaluated the acceptability of the program. Results: The scheduled patients were more likely to be single, of no fixed abode and without a local family. They were more likely to have a schizophrenic disorder, compounded by polysubstance abuse, than a mood disorder. The average inpatient stay for those roomed-in was 10 days. Seventy per cent of confidants were required for 4 days or less. The rooming-in program was valued highly by nursing staff, patients and their families. Conclusion: A search of the world literature would suggest that rooming-in, as a model of care, is unique, at least in the developed world. It allows some seriously disturbed patients to be provided with a local and less restrictive general hospital alternative.
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Hancock, Nicola, Bridget Berry, Michelle Banfield, Georgia Pike-Rowney, Justin Newton Scanlan, and Sarah Norris. "Peer Worker-Supported Transition from Hospital to Home—Outcomes for Service Users." International Journal of Environmental Research and Public Health 19, no. 5 (February 26, 2022): 2743. http://dx.doi.org/10.3390/ijerph19052743.
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Background: Transitioning from psychiatric hospitalisation back to community presents a period of heightened suicide, homelessness, relapse, and rehospitalisation risk. The Australian state of New South Wales established a state-wide Peer Supported Transfer of Care (Peer-STOC) initiative to enhance recovery-focused supports available during this transition period. Aims: To understand the impacts and outcomes of the Peer-STOC program on service users from three stakeholder perspectives: service users themselves, peer worker service providers, and other mental health workers and clinicians interfacing with the program. Methods: Qualitative data from 82 questionnaires and 58 individual in-depth interviews were analysed thematically using constant comparative methods and an iterative and inductive process. Results: All stakeholders described positive impacts and outcomes of the program for service users. These included: (a) a better, less traumatic inpatient experience; (b) felt understood, cared about and less alone; (c) easier to leave hospital; (d) easier to get back into life and daily routines; (e) built and re-established community connections; (f) gained new knowledge, strategies, and skills; and (g) felt more hopeful about my recovery. Conclusions: The Peer-STOC program had a positive impact. It enhanced people’s experience in hospital, eased their transition from hospital and assisted with people recovering community-based relationships, activities, and routines.
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Harris, Anthony, Wendy Chen, Sharon Jones, Melissa Hulme, Philip Burgess, and Grant Sara. "Community treatment orders increase community care and delay readmission while in force: Results from a large population-based study." Australian & New Zealand Journal of Psychiatry 53, no. 3 (February 27, 2018): 228–35. http://dx.doi.org/10.1177/0004867418758920.
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Objective: There is debate about the effectiveness of community treatment orders in the management of people with a severe mental illness. While some case–control studies suggest community treatment orders reduce hospital readmissions, three randomised controlled trials find no effects. These randomised controlled trials measure outcomes over a longer period than the community treatment order duration and assess the combined effectiveness of community treatment orders both during and after the intervention. This study examines the effectiveness of community treatment orders in a large population-based sample, restricting observation to the period under a community treatment order. Methods: All persons ( n = 5548) receiving a community treatment order in New South Wales, Australia, over the period 2004–2009 were identified. Controls were matched using a propensity score based on demographic, clinical and prior care variables. A baseline period equal to each case’s duration of treatment was constructed. Treatment effects were compared using zero-inflated negative binomial regression, adjusting for demographics, clinical characteristics and pre-community treatment order care. Results: Compared to matched controls, people on community treatment orders were less likely to be readmitted (odds ratio = 0.90, 95% confidence interval = [0.84, 0.97]) and had a significantly longer time to their first readmission (incidence rate ratio = 1.47, 95% confidence interval = [1.36, 1.58]), fewer hospital admissions (incidence rate ratio = 0.90, 95% confidence interval = [0.84, 0.96]) and more days of community care (incidence rate ratio = 1.55, 95% confidence interval = [1.51, 1.59]). Increased community care and delayed first admission were found for all durations of community treatment order care. Reduced odds of readmission were limited to people with 6 months or less of community treatment order care, and reduced number of admissions and days in hospital to people with prolonged (>24 months) community treatment order care. Conclusion: In this large population-based study, community treatment orders increase community care and delay rehospitalisation while they are in operation. Some negative findings in this field may reflect the use of observation periods longer than the period of active intervention.
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Paterson, Tom, Christopher Seiboth, Barbara Magin, Rajan Nagesh, Cyndy Lloyd, and Helena Williams. "An initiative in primary care psychiatry in South Australia." Australasian Psychiatry 10, no. 3 (September 2002): 259–64. http://dx.doi.org/10.1177/103985620201000313.
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Objective: To describe a joint mental health project involving the Adelaide Northern Division of General Practice (ANDGP) and the North West Adelaide Mental Health Service (NWAMHS). Conclusions: This project has been developed to explore alternative strategies to facilitate the identification and management of patients with mental illness in the primary care setting. The project has also endeavoured to explore alternative types of psychiatrist/general practitioner interactions other than the conventional ‘general practitioner referred psychiatrist consultation’. The development of adequate and clinically relevant evaluation methods, both quantitative and qualitative, has also been an explicit objective of the project. While the project provides an exciting stimulus for ongoing development of models of Primary Psychiatric Care, it is evident that such models can only evolve in the context of significant service and systemic change. It is hoped that the experiences in the northern suburbs of Adelaide can stimulate others to explore the ongoing collaborations between psychiatric services and general practitioners in ways that can produce better mental health outcomes in our patients.
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Gater, Richard, and David Goldberg. "Pathways to Psychiatric Care in South Manchester." British Journal of Psychiatry 159, no. 1 (July 1991): 90–96. http://dx.doi.org/10.1192/bjp.159.1.90.
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Of 250 patients newly referred to the mental illness services of South Manchester, almost two-thirds were referred directly by their GPs; a further third were referred by hospital doctors. Non-medical sources of referral accounted for only 2% of new cases. Patients with somatic problems had the longest interval between seeking care and referral to the psychiatric services. Being employed was associated with a longer delay before seeking care; among women, those living with their husbands or children had longer total intervals between the onset of the problem and arrival at the psychiatric services.
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Looi, Jeffrey CL, Tarun Bastiampillai, William Pring, Stephen R. Kisely, and Stephen Allison. "Private psychiatric hospital care in Australia: a descriptive analysis of casemix and outcomes." Australasian Psychiatry 30, no. 2 (November 27, 2021): 174–78. http://dx.doi.org/10.1177/10398562211051252.
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Objective: To provide a rapid clinical update on casemix, average length of stay, and the effectiveness of Australian private psychiatric hospitals. Methods: We conducted a descriptive analysis of the publicly available patient data from the Australian Private Hospitals Association Private Psychiatric Hospitals Data Reporting and Analysis Service website, from 2015–2016 to 2019–2020. This was compared with corresponding reporting on public and private hospitals from the Australian Institute of Health and Welfare, and Australian Mental Health Outcomes and Classification Network. Results: In 2019–2020, there were 72 private psychiatric hospitals in Australia with 3582 acute beds. There were 42,942 inpatients with 1,286,470 days of care, and a mean length of stay 19.6 days (SD 13.9) for the financial year 2019–2020. The main diagnoses were major affective and other mood disorders (49%), and alcohol and other substance abuse disorders (21%). Clinician-rated outcome measures, that is, the HoNOS, showed an improvement effect size of 1.64, while the patient-rated MHQ-14 showed an improvement effect size of 1.18. Results are similar for previous years. Conclusions: Private psychiatric hospitals provide substantial, effective psychiatric care.
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Draper, Brian, and Lee-Fay Low. "Psychiatric services for the “old” old." International Psychogeriatrics 22, no. 4 (March 15, 2010): 582–88. http://dx.doi.org/10.1017/s1041610210000293.
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ABSTRACTBackground: Few studies have specifically examined mental health service delivery to persons aged over 84 years, often described as the “old” old. Our aim was to compare mental health service provision in Australia to persons aged 85 years and over with the “young” old and other age groups. We hypothesized that the “old” old would differ from the “young” old (65–84 years) by diagnostic category, rates of specialist psychiatric hospital admission, and use of Medicare funded psychiatric consultations in the community.Methods: Mental health service delivery data for 2001–02 to 2005–06 was obtained from Medicare Australia on consultant psychiatrist office-based, home visit and private hospital services subsidized by the national healthcare program and the National Hospital Morbidity database for separations (admitted episodes of patient care) from all public and most private hospitals in Australia on measures of age, gender, psychiatric diagnosis, location and type of psychiatric care.Results: Use of specialist psychiatric services in the community per annum per 1000 persons declined with age in men and women from 137.28 and 191.87 respectively in those aged 20–64 years to 11.84 and 14.76 respectively in those over 84 years. However, men and women over 84 years received psychiatric home visits at 377% and 472% respectively of the rates of persons under 65. The annual hospital separation rate per 1000 persons for specialist psychiatric care was lowest in those aged over 84 (3.98) but for inpatient non-specialized psychiatric care was highest in those over 84 (21.20). Depression was the most common diagnosis in specialized psychiatric hospitalization in those aged over 84 while organic disorders predominated in non-specialized care in each age group over 64 years with the highest rates in those aged over 84.Conclusion: Mental health service delivery to persons aged over 84 is distinctly different to that provided to other aged groups being largely provided in non-specialist hospital and residential settings.
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Boerma, Bernard, Robert Hayes, Alissa Moen, and Anthony T. Williams. "Recent changes in mental health legislation and government policy in psychiatric care in Australia." Psychiatric Bulletin 19, no. 5 (May 1995): 293–95. http://dx.doi.org/10.1192/pb.19.5.293.
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There have been a number of recent changes in mental health care legislation in Australia some of which mirror the changes that have occurred in the UK. These are reviewed within the context of the differing health care system in Australia and with particular reference to the State of New South Wales.
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Ronnau, Peggy, Arthur Papakotsias, and Glen Tobias. ""Not for" sector in community mental health care defines itself and strives for quality." Australian Journal of Primary Health 14, no. 2 (2008): 68. http://dx.doi.org/10.1071/py08025.
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This paper briefly describes the history and service context of the Psychiatric Disability Rehabilitation and Support sector (PDRSS) in Victoria, and, to a lesser extent, in New South Wales, South Australia and Western Australia. In describing the sector we will call upon the experience of a particular PDRSS - Neami - in operating and developing services, and the challenges it faced in establishing a culture of quality that directly improves consumer outcomes. Elements of this experience may serve as a guide in the development of mental health service policy at state and federal level.
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Beckmann, Kerri R., Ian N. Olver, Brenda Wilson, David M. Roder, Linda M. Foreman, and Graeme P. Young. "Patient and carer perceptions of cancer care in South Australia." Australian Health Review 33, no. 4 (2009): 645. http://dx.doi.org/10.1071/ah090645.
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Quality of care from the patient?s perspective is an increasingly important outcome measure for cancer services. Patients? and carers? perceptions of cancer care were assessed through structured telephone interviews, 4?10 months post-discharge, which focused on experiences during the most recent hospital admission. A total of 481 patients with a primary diagnosis of cancer (ICD-10 C codes) were recruited, along with 345 carers nominated by the patients. Perceptions of clinical care were generally positive. Less positive aspects of care included not being asked how they were coping, not being offered counselling, and not receiving written information about procedures. Results also highlighted inadequate discharge processes. Carers were more likely than patients to report negative experiences. Perceptions of care also differed by cancer type.
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Rossi, Alberto, Vera Morgan, Francesco Amaddeo, Marco Sandri, Michele Tansella, and Assen Jablensky. "Psychiatric Out-Patients Seen Once Only in South Verona and Western Australia: A Comparative Case-Register Study." Australian & New Zealand Journal of Psychiatry 39, no. 5 (May 2005): 414–22. http://dx.doi.org/10.1080/j.1440-1614.2005.01590.x.
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Objective: This study examined variables associated with having a once-only contact with the out-patient department of two community mental health services in Italy and Australia. Method: Two 8-year cohorts of patients, who had a new episode of care with out-patient psychiatric departments in South Verona and in Western Australia, were followed-up for 3 months after the first contact, to identify those patients who had no further contact with services. Potential determinants of once-only contact were analysed. Results: Thirty percent of new episodes of care for persons who met the inclusion criteria of the study were once-only contacts with the service in South Verona. In Western Australia, the figure was 24%. Moreover, the proportion of once-only contact patients has increased over time in South Verona whereas, in Western Australia, it has remained stable. In Western Australia, once-only contact patients were younger whereas in South Verona they tended to be older. At both research sites, patients who had a once-only contact were more likely to be male and to have a less severe mental illness. Conclusions: The results of this study suggest that only clinical characteristics were significant determinants of this pattern of contact with services consistently at both sites: the less severe the patient's diagnosis, the more likely the patient is to have a once-only contact. This may well indicate good screening at the initial point of contact by both sets of mental health service providers. Prospective studies are necessary to clarify the problem of ‘onceonly contact’ and to organize a proper psychiatric care.
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Bruxner, George, Peter Burvill, Sam Fazio, and Sam Febbo. "Aspects of Psychiatric Admissions of Migrants to Hospitals in Perth, Western Australia." Australian & New Zealand Journal of Psychiatry 31, no. 4 (August 1997): 532–42. http://dx.doi.org/10.3109/00048679709065075.
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Objective: Recent Australian Government initiatives have emphasised problems with service provision to the ethnic mentally ill. This study aims to address the paucity of contemporary data describing the disposition of the ethnic mentally ill in hospital settings. Method: Patterns of admissions for psychiatric disorders to all hospitals in Perth, Western Australia, for the 3 years from 1990 to 1992, of migrants and the Australian born were compared using data from the Western Australian Mental Health Information System. Results: The overall rates for European migrants showed a ‘normalisation’ towards those of the Australian-born. There were high rates for the schizophrenic spectrum disorders in Polish and Yugoslavian (old terminology) migrants. There were low admission rates for South-East Asian migrants, predominantly those from Vietnam and Malaysia. Rates for alcoholism were low in Italian and all Asian migrants. There were high rates of organic psychosis, especially in those older than 75 years, among the Italian and Dutch migrants. The relative risk of a first admission in the 3 years being an involuntary admission to a mental hospital was almost twice that of the Australian-born for migrants from Poland, Yugoslavia, Malaysia and Vietnam. Conclusions: The results imply the possibility of significant untreated and/or undiagnosed psychiatric morbidity in the South-East Asian-born. They also indicate a need for further exploration of the unexpectedly high levels of psychiatric morbidity among some ethnic elderly groups, specifically the Dutch- and Italian-born. The findings demonstrate the persistence of high rates of presentation for psychotic disorders among Eastern European-born populations, many years post migration.
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McLoughlin, Maire. "Day care and a hostel – a cost effective approach." Psychiatric Bulletin 14, no. 4 (April 1990): 203–5. http://dx.doi.org/10.1192/pb.14.4.203.
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In order to plan a comprehensive psychiatric service for County Clare, it was necessary to divide the county into four sectors, North, East, South and West. The area I am discussing is the West Sector, which covers 800 square kilometres and has a population of 20, 000. Kilrush town is the capital of the West Sector situated 50 kilometres from the main hospital in Ennis. Psychiatric morbidity was noted to be high in this rural area. Prior to opening a Day Hospital in Kilrush (May 1986) we were using 15 beds in the acute unit. Now we are using, on average, five beds at any given time.
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Choi, Young, Chung Mo Nam, Sang Gyu Lee, Sohee Park, Hwang-Gun Ryu, and Eun-Cheol Park. "Association of continuity of care with readmission, mortality and suicide after hospital discharge among psychiatric patients." International Journal for Quality in Health Care 32, no. 9 (August 14, 2020): 569–76. http://dx.doi.org/10.1093/intqhc/mzaa093.
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Abstract Objectives The objective of this study was to identify the association between continuity of ambulatory psychiatric care after hospital discharge among psychiatric patients and readmission, mortality and suicide. Design Nationwide nested case-control study. Settings South Korea. Participants Psychiatric inpatients. Interventions Continuity of psychiatric outpatient care was measured from the time of hospital discharge until readmission or death occurred, using the continuity of care index. Main Outcome Measures Readmission, all-cause mortality and suicides within 1-year post-discharge. Results Of 18 702 psychiatric inpatients in the study, 8022 (42.9%) were readmitted, 355 (1.9%) died, and 108 (0.6%) died by suicide within 1 year after discharge. Compared with the psychiatric inpatients with a high continuity-of-care score, a significant increase in the readmission risk within 1 year after discharge was found in those with medium and low continuity of care scores. An increased risk of all-cause mortality within 1 year after hospital discharge was shown in the patients in the low continuity group, relative to those in the high-continuity group. The risk of suicide within 1 year after hospital discharge was higher in those with medium and low continuity of care than those with high continuity of care. Conclusion The results of this study provide empirical evidence of the importance of continuity of care when designing policies to improve the quality of mental health care, such as increasing patient awareness of the importance of continuity and implementation of policies to promote continuity.
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Mokwena, Kebogile Elizabeth, and Jabulile Ndlovu. "Why Do Patients with Mental Disorders Default Treatment? A Qualitative Enquiry in Rural Kwazulu-Natal, South Africa." Healthcare 9, no. 4 (April 14, 2021): 461. http://dx.doi.org/10.3390/healthcare9040461.
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Although treatment default by psychiatric patients or mental health care users is a global challenge, this behavior is reported to be higher in South Africa. The Manguzi District Hospital in rural Kwa-Zulu Natal Province, South Africa, experiences high rates of treatment default by psychiatric patients. The objective of this study was to determine the reasons for treatment defaulting at Manguzi Hospital, KwaZulu-Natal Province, South Africa. An explorative qualitative design, using in-depth interviews, was conducted with mental health care users who had defaulted out-patient psychiatric treatment. Twenty-one mental health care users were interviewed before data saturation was reached. Nvivo version 11 was used to analyze the qualitative data. Major themes that emerged confirmed that social factors are key contributions to treatment defaulting, and these include denial of the mental disorders; belief that they are cured; lack of, or disintegration of social support; preference for traditional medicine; and flaws in the health care system. Social determinants of treatment outcomes for mental disorders require tailor-made support systems for patients in these rural communities, which include increase in health literacy and attention to the cultural understanding of mental disorders.
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Gater, Richard, Francesco Amaddeo, Michele Tansella, Gayle Jackson, and David Goldberg. "A Comparison of Community-Based Care for Schizophrenia in South Verona and South Manchester." British Journal of Psychiatry 166, no. 3 (March 1995): 344–52. http://dx.doi.org/10.1192/bjp.166.3.344.
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BackgroundThe community-oriented mental illness services providing care to defined populations in south Verona, Italy (17 628 adults) and south Manchester, England (12 021 adults) have been compared to explore relationships between service organisation and patterns of service use.MethodThe composition and function of the two services and the sociodemographic characteristics of the two centres are described and related to epidemiological data on service use in the community, out-patient clinic, day hospital and in-patient care.ResultsTreated incidence of all psychiatric diagnoses and of schizophrenia were significantly higher in south Manchester than south Verona, indicating that the referral filter between primary and secondary care is more permeable in Manchester. Patients known to the service were more likely to be admitted and to have shorter in-patient stays in south Verona, indicating that the filter between in-patient care and the community is more permeable in Verona than Manchester.ConclusionsThe organisation of services in Verona results in a smaller load on the mental health service; the shorter hospital stays can be related to better integration between hospital and community resources. The organisation of services in Manchester provides care for a greater proportion of the population, but would be likely to require increased resources for the mental health services over time.
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Hegde, Soumya G., YR Niranjan Hebbar, and Swathi. "Psychiatric comorbidities among patients of Prurigo nodularis: A cross sectional study in tertiary care hospital south India." Our Dermatology Online 14, e (January 21, 2023): e14-e14. http://dx.doi.org/10.7241/ourd.2023e.14.
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Background: Prurigo nodularis (PN) is a dermatologic itchy condition which affects the normal day to day life activities. Due to its chronic condition psychiatric comorbidities are regularly seen in these patients. Due to scarcity of literature in Indian background this study was conducted in our tertiary care centre. Materials and methodology: It was a descriptive, cross sectional study conducted at department of dermatology during May 2021 to April 2022 where all diagnosed PN patients were screened for psychiatric comorbidities using MINI- International Neuropsychiatric interview. Results: We found Generalised Anxiety Disorder among 27.2% and Major Depressive Disorder among 15.8% of study population. Also Social phobia among 16.8% of males. Majority of 61% in both males and females didn’t had any psychiatric disorders in our study sample. Conclusion: Higher incidences of anxiety, depressio
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Hillen, Jodie B., Richard L. Reed, Richard J. Woodman, Deborah Law, Paul H. Hakendorf, and Brian J. Fleming. "Hospital admissions from residential aged care facilities to a major public hospital in South Australia (1999-2005)." Australasian Journal on Ageing 30, no. 4 (November 11, 2010): 202–7. http://dx.doi.org/10.1111/j.1741-6612.2010.00479.x.
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Sood, Mamta, and Rakesh K. Chadda. "Psychosocial rehabilitation for severe mental illnesses in general hospital psychiatric settings in South Asia." BJPsych. International 12, no. 2 (May 2015): 47–48. http://dx.doi.org/10.1192/s2056474000000301.
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In South Asia, general hospital psychiatric units (GHPUs) have developed as an alternative to mental hospitals for the provision of comprehensive mental health services, training and research. GHPUs provide clinical care for all types of patients, including those with severe mental illnesses (SMIs). However, psychosocial rehabilitation is often neglected in GHPUs, partly because of the predominance of the medical model in routine clinical care and a lack of resources. This paper discusses the challenges in the management of SMIs in GHPUs and proposes a model of psychosocial rehabilitation which could be used in such settings.
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KISELY, STEPHEN, MARK SMITH, NEIL J. PRESTON, and JIANGUO XIAO. "A comparison of health service use in two jurisdictions with and without compulsory community treatment." Psychological Medicine 35, no. 9 (September 2005): 1357–67. http://dx.doi.org/10.1017/s0033291705004824.
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Background. This study examines whether community treatment orders (CTOs) reduce psychiatric admission rates or bed-days for patients from Western Australia compared to control patients from a jurisdiction without this legislation (Nova Scotia).Method. A population-based record linkage analysis of an inception cohort using a two-stage design of matching and multivariate analyses to control for sociodemographics, clinical features and psychiatric history. All discharges from in-patient psychiatric services in Western Australia and Nova Scotia were included covering a population of 2·6 million people. Patients on CTOs in the first year of implementation in Western Australia were compared with controls from Nova Scotia matched on date of discharge from in-patient care, demographics, diagnosis and past in-patient psychiatric history. We analysed time to admission using Cox regression analyses and number of bed-days using logistic regression.Results. We matched 196 CTO cases with an equal number of controls. On survival analyses, CTO cases had a significantly greater readmission rate. Co-morbid personality disorder and previous psychiatric history were also associated with readmission. However, on logistic regression, patients on CTOs spent less time in hospital in the following year, with reduced in-patient stays of over 100 days.Conclusions. Although compulsory community treatment does not reduce hospital admission rates, increased surveillance of patients on CTOs may lead to earlier intervention such as admission, so reducing length of hospital stay. However, we do not know if it is the intensity of treatment, or its compulsory nature, that effects outcome.
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Mosel, Krista A., Adam Gerace, and Eimear Muir-Cochrane. "Retrospective analysis of absconding behaviour by acute care consumers in one psychiatric hospital campus in Australia." International Journal of Mental Health Nursing 19, no. 3 (June 2010): 177–85. http://dx.doi.org/10.1111/j.1447-0349.2009.00660.x.
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Pillay, Anthony L., Naseema B. M. Vawda, Leslie R. Pollock, and Wynand F. du Plessis. "Demographic and Readmission Data in a Therapeutic Community for Black Psychiatric Patients in South Africa." Australian & New Zealand Journal of Psychiatry 28, no. 4 (December 1994): 684–88. http://dx.doi.org/10.1080/00048679409080792.
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Therapeutic communities have an important role in adult psychiatric care. Such a hospital unit is described within a Black psychiatric hospital in South Africa. However, owing to apartheid very few Black clinical psychologists have been trained. Translators frequently have to be used in the therapeutic context, which is an unorthodox approach. Nevertheless, various therapeutic groups are conducted. Demographic and clinical data for a 3 year period are presented, showing most of the patients to be male, unmarried and around 30 years of age. Schizophrenic conditions were the most common diagnoses, with problems of self-care and low self-esteem predominating. Although a readmission rate of 22.1% was noted the lack of adequate control measures in this study must be taken into consideration.
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Raja, Sreecanth Sibhi, Suzanne Edwards, Jeffrey Stewart, and Dep Huynh. "Missed opportunities for hepatitis C treatment at a tertiary care hospital in South Australia." World Journal of Hepatology 14, no. 8 (August 27, 2022): 1576–83. http://dx.doi.org/10.4254/wjh.v14.i8.1576.
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O’Connor, Nick, Katherine Zantos, and Viviana Sepulveda-Flores. "Use of personal electronic devices by psychiatric inpatients: benefits, risks and attitudes of patients and staff." Australasian Psychiatry 26, no. 3 (February 20, 2018): 263–66. http://dx.doi.org/10.1177/1039856218758564.
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Objectives: The study aimed to evaluate the attitudes of patients and staff in relation to the potential benefits and risks of allowing psychiatric inpatients controlled access to personal electronic devices (PEDs), and to document a snapshot audit of practice within the mental health inpatient units of New South Wales, Australia. Methods: Psychiatric inpatients and staff at Royal North Shore Hospital’s Mental Health inpatient units were surveyed, and an audit of the policies of the psychiatric inpatients of New South Wales was undertaken. Results: Access to PEDs is denied in 85% of New South Wales psychiatric inpatient units. While patients and staff appear to concur on the risks of access to PEDs and the need for risk assessment and rules, compared to patients, staff appear to underestimate the importance of PEDs to maintaining social connection and recovery. Conclusions: This study may assist in the formulation of local policy and procedure to allow a more recovery-oriented approach to the question of whether patients should have access to their PEDs while in hospital.
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Lawrence, David M., Cashel D'Arcy, J. Holman, Assen V. Jablensky, and Michael S. T. Hobbs. "Death rate from ischaemic heart disease in Western Australian psychiatric patients 1980–1998." British Journal of Psychiatry 182, no. 1 (January 2, 2003): 31–36. http://dx.doi.org/10.1192/bjp.182.1.31.
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BackgroundPeople with mental illness suffer excess mortality due to physical illnesses.AimsTo investigate the association between mental illness and ischaemic heart disease (IHD) hospital admissions, revascularisation procedures and deaths.MethodA population-based record-linkage study of 210 129 users of mental health services in Western Australia during 1980–1998. IHD mortality rates, hospital admission rates and rates of revascularisation procedures were compared with those of the general population.ResultsIHD (not suicide) was the major cause of excess mortality in psychiatric patients. In contrast to the rate in the general population, the IHS mortality rate in psychiatric patients did not diminish over time. There was little difference in hospital admission rates for IHD between psychiatric patients and the general community, but much lower rates of revascularisation procedures with psychiatric patients, particularly in people with psychoses.ConclusionsPeople with mental illness do not receive an equitable level of intervention for IHD. More attention to their general medical care is needed.
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Assareh, Hassan, Helen M. Achat, Jean-Frederic Levesque, and Stephen R. Leeder. "Exploring interhospital transfers and partnerships in the hospital sector in New South Wales, Australia." Australian Health Review 41, no. 6 (2017): 672. http://dx.doi.org/10.1071/ah16117.
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Objective The aim of the present study was to explore characteristics of interhospital transfers (IHT) and sharing of care among hospitals in New South Wales (NSW), Australia. Methods Data were extracted from patient-level linked hospital administrative datasets for separations from all NSW acute care hospitals from 1 July 2013 to 30 June 2015. Patient discharge and arrival information was used to identify IHTs. Characteristics of patients and related hospitals were then analysed. Results Transfer-in patients accounted for 3.9% of all NSW admitted patients and, overall, 7.3% of NSW admissions were associated with transfers (IHT rate). Patients with injuries and circulatory system diseases had the highest IHT rate, accounting for one-third of all IHTs. Patients were more often transferred to larger than smaller hospitals (61% vs 29%). Compared with private hospitals, public hospitals had a higher IHT rate (8.4% vs 5.1%) and a greater proportion of transfer-out IHTs (52% vs 28%). Larger public hospitals had lower IHT rates (3–8%) compared with smaller public hospitals (13–26%). Larger public hospitals received and retransferred higher proportions of IHT patients (52–58% and 11% respectively) than their smaller counterparts (26–30% and 2–3% respectively). Less than one-quarter of IHTs were between the public and private sectors or between government health regions. The number of interacting hospitals and their interactions varied across hospital peer groups. Conclusion NSW IHTs were often to hospitals with greater speciality services. The patterns of interhospital interactions could be affected by organisational and regional preferences. What is known about the topic? IHTs aim to provide efficient and effective care. Nonetheless, information on transfers and the sharing of care among hospitals in an Australian setting is lacking. Studies of transfers and hospital partnership patterns will inform efforts to improve patient-centred transfers and hospital accountability in terms of end outcomes for patients. What does this paper add? Transfer-in patients accounted for 3.9% of all NSW admissions; they were often (61%) transferred to hospitals with greater speciality services. The number of IHTs and sharing of care among hospitals varied across hospital peer groups, and could have been affected by organisational and regional preferences. What are the implications for practitioners? The findings of the present study suggest that different patterns of IHTs may not only have resulted from clinical priorities, but that organisational and regional preferences are also likely to be influential factors. Patient-centred IHTs and the development of guidelines need to be pursued to enhance the care and functionality of healthcare. Patient sharing should be acknowledged in hospital and regional performance profiling.
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Gowda, Guru S., Channaveerachari Naveen Kumar, Sujoy Ray, Soumitra Das, Raveesh Bevinahalli Nanjegowda, and Suresh Bada Math. "Caregivers’ attitude and perspective on coercion and restraint practices on psychiatric inpatients from South India." Journal of Neurosciences in Rural Practice 10, no. 02 (April 2019): 261–66. http://dx.doi.org/10.4103/jnrp.jnrp_302_18.
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ABSTRACT Background: Coercion and restraint practices in psychiatric care are common phenomena and often controversial and debatable ethical issue. Caregivers’ attitude and perspective on coercion and restraint practices on psychiatric inpatients have received relatively less research attention till date. Aims: Caregivers’ attitude and perspective on coercion and restraint practices on psychiatric inpatients. Methodology: This is a hospital-based, a descriptive, cross-sectional study. A total of 200 (n = 200) consecutive patient and their caregivers were chosen between June 2013 and September 2014 through computer-generated random numbers sampling technique. We used a semi-structured interview questionnaire to capture caregivers’ attitude and perspective on coercion and restraint practices. Sociodemographic and coercion variable were analyzed using descriptive statistics. McNemar test was used to assess discrete variables. Results: The mean age was 43.8 (±14.9) years. About 67.5% of the caregivers were family members, 60.5% of them were male and 69.5% were from low-socioeconomic status. Caregivers used multiple methods were used to bring patients into the hospital. Threat (52.5%) was the most common method of coercion followed by persuasion (48.5%). Caregivers felt necessary and acceptable to use chemical restraint (82.5%), followed by physical restraint (71%) and electroconvulsive therapy (ECT) (56.5%) during acute and emergency psychiatric care to control imminent risk behavior of patients. Conclusion: Threat, persuasion and physical restraint were the common methods to bring patients to bring acutely disturbed patients to mental health care. Most patients caregivers felt the use of chemical restraint, physical restraint and ECT as necessary for acute and emergency care in patients with mental illness.
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Holloway, Frank, Gaius Davies, Marisa Silverman, and Tony Wainwright. "How Many Beds? A survey of needs for treatment and care in an in-patient unit." Bulletin of the Royal College of Psychiatrists 12, no. 3 (March 1988): 91–94. http://dx.doi.org/10.1192/s0140078900021271.
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Over the past 20 years the Department of Psychological Medicine at King's College Hospital has gradually taken responsibility for the provision of psychiatric services to the East Lambeth sector of the Camberwell Health District. A small District General Hospital (DGH) in-patient unit was opened in 1972, and since then it has been the aim of the Department to provide a comprehensive locally based psychiatric service. Slow progress has been made compared with the developments that have taken place in the South Southwark sector of the District, which have been fostered by the Maudsley Hospital. With the impending closure of Cane Hill Hospital, on which the District has historically relied, the object of a completely local service is rapidly becoming a reality. Releasing the resources hitherto tied to the large institution presents an unparallelled opportunity for change.
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Gazdag, G., Z. Grenda, and R. Takács. "Inpatient psychiatric care of COVID-19 infected patients in a Hungarian general hospital." European Psychiatry 65, S1 (June 2022): S202. http://dx.doi.org/10.1192/j.eurpsy.2022.530.
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Introduction during the study period (08/02/2021 – 11/05/2021) the Centre of Psychiatry in the Jahn Ferenc South-pest Hospital (CP-JFSH) was one of the two psychiatric wards in Budapest, specialized for the treatment of COVID-19 infected psychiatric patients. Objectives the aim of the study was to survey the characteristics and evaluate the outcome of the COVID-19 infected psychiatric patients treated in the CP-JFSH. Methods retrospective analysis of the files of COVID-19 infected psychiatric patients admitted to the CP-JFSH in a 3 month period. In addition to demographic data, diagnostic distribution, co-morbidities, date of infection, method of detection of the virus, presence of pneumonia, severity of infection, outcome, treatment, vaccination data were evaluated. Results in the study period 124 COVID-19 infected psychiaric patients were admitted to the CP-JFSH. The gender distribution was aproximately equal, the mean age of the patients was 62.8+/-15.7 years. Majority of the patients suffered from major neurocognitive disorder followed by schizophrenia spectrum disorder. Most common co-morbidities were cardiovascular diseases and diabetes. Pneumonia was present in 41% of the patients. Majority of the patients were already infected at the time of admission, detected with the first PCR examination and haven’t been vaccinated yet. Thirty-one percent of the patients suffered from moderate to severe COVID-19 illness. COVID-19 specific therapy (favipiravir, remdesivir, fluvoxamin) was introduced in 57%. Mortality was 12% while the relaps rate 4%. Conclusions comparing with inpatient mortality rate published in the literature, mortality rate was higher among psychiatric patients, underlining the need for special attention of this population. Disclosure No significant relationships.
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Batool Shah, Seema, Mansoor Ahmad Dar MD, and Pinki Kumari MD. "CLINICAL AND SOCIODEMOGRAPHIC PROFILE OF PATIENTS PRESENTING TO CONSULTATION LIAISON PSYCHIATRY CARE IN A TERTIARY CARE HOSPITAL IN SOUTH KASHMIR." International Journal of Advanced Research 10, no. 01 (January 31, 2022): 1098–103. http://dx.doi.org/10.21474/ijar01/14150.
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Background: Consultation-liaison psychiatry is a sub specialty of Psychiatry that involves the study, practice and teaching of the relation between medical and psychiatric disorders. There is relatively insufficient data that studies the profile of consultation-liaison psychiatry across developing nations. Aims:To study the clinical and sociodemographic profile of patients presenting to consultation-liaison psychiatry care in a tertiary care hospital in south Kashmir. Materials & Methods:The present study included all the patients who were referred to Psychiatric department ,both inpatients as well as outpatients ,over a period of one year from January 2020 to December 2020.Data was collected using a semi structured pro forma and diagnosis was made using ICD-10 diagnostic criteria. Results:600 patients were included in our study, 332 of whom were females. Majority of patients belonged to age group of 21-40 and were residents of urban areas. The most common source of referrals included Cardiology followed by General Medicine. Depressive symptoms followed by suicidal attempts formed the majority of reasons for referral. The most common diagnosis established was Major Depression followed by Substance Use disorders. Conclusion: C L Psychiatry plays a significant role in bridging the gap between physical and mental illness and is vital for providing an integrated health service to the patients.
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Rosenman, Stephen. "Psychiatric bed usage under different systems of care. A comparison of South Verona (Italy) and Canberra (Australia)." Epidemiologia e Psichiatria Sociale 3, no. 3 (December 1994): 163–70. http://dx.doi.org/10.1017/s1121189x00003663.
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RiassuntoScopo - Confrontare l'uso dei servizi ospedalieri per le principali malattie psichiatriche in una struttura che offre un «servizio psichiatrico territoriale» (Verona-Sud, Italia) con l'uso di questi servizi in una struttura più «tradizionale», dove l'ospedale è il centro dell'attività (Canberra, Australia). Disegno - Sono stati esaminati i registri dei ricoveri per i malati da psicosi schizofreniche e distimiche negli anni 1986, 1987 e 1988. Sono state comparate le seguenti caratteristiche: la mappa socio-demografica ed i tassi dei ricoveri per i pazienti, la durata del ricovero iniziale ed i tassi di ri-ricovero per questi pazienti nei dodici mesi seguenti. Risultati - Il servizio psichiatrico territoriale (Verona-Sud) ha ricoverato meno pazienti con psicosi schizofreniche e distimiche ma questi risultavano più gravi, restavano degenti più a lungo ed avevano una probabilità maggiore di essere ricoverati nuovamente. Il servizio psichiatrico «tradizionale» (Canberra) ha usato l'ospedale per una gamma più ampia di malattie, incluse le malattie con buona prognosi. La degenza in Canberra è stata più breve ed il ri-ricovero meno frequente. Sembra che il servizio «tradizionale» sia più orientato ad usare l'ospedale per l'inizio o per la stabilizzazione della terapia. Il servizio psichiatrico territoriale non portava ad una degenza più breve o ad un numero minore di ricoveri successivi al primo. Le differenze nella morbilità psichiatrica incontrata nelle popolazioni ha nascosto l'effetto della struttura del servizio sull'uso. Questa differenza nella distribuzione della morbilitù psichiatrica concentrata nel gruppo di più giovane età, rimane senza spiegazione.
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Arreghini, Ermanno, Claudio Agostini, and Greg Wilkinson. "General practitioner referral to specialist psychiatric services: a comparison of practices in North- and South-Verona." Psychological Medicine 21, no. 2 (May 1991): 485–94. http://dx.doi.org/10.1017/s0033291700020596.
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SYNOPSISSpecialist psychiatric services run by the Italian National Health Service are mainly hospital-based in North-Verona and community-based in South-Verona. Ninety-two GPs from both areas participated in a one-day survey of their provision of psychiatric care, and this paper focuses on socio-demographic and clinical variables associated with specialist psychiatric referral. The one-day prevalence figure for GP referral to specialist psychiatric services was 7·3% (17·6/10000): the figures did not differ between the sexes or between the two areas. Whereas in North-Verona 49% of the patients referred were sent to the two local hospital-based public services and 51% to other agencies (mainly to private psychiatrists), in South-Verona 71% of referrals were to the community-based public service.Log-linear analysis showed that past psychiatric history, psychological presenting complaint, social problems and GPs' psychiatric diagnosis exerted positive joint main effects on GP referral to specialist psychiatric services, and that diagnosed organic illness had a negative effect in this regard. In the presence of a psychological complaint, a psychiatric diagnosis proved to be quite unimportant, so that those without a psychiatric diagnosis were just as likely to be referred as those with one. However, in the absence of a psychological complaint a GP diagnosis of depression greatly increased the risk of referral.Though the type of psychiatric service proved not to be an important determinant of GP referral to specialist psychiatric services it influenced the GPs' choice of referral agency.
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McBride, K., W. Keech, V. Shtangey, J. Xiang, O. Pearson, and A. Brown. "Exploring Disparities in In-Hospital Cardiac Care and Outcomes for Aboriginal People in South Australia." Heart, Lung and Circulation 27 (2018): S412. http://dx.doi.org/10.1016/j.hlc.2018.06.832.
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Thothela, S., A. E. Van der Wath, and E. S. Janse van Rensburg. "FACTORS CONTRIBUTING TO RELAPSE OF MENTAL HEALTH CARE USERS TREATED FOR SUBSTANCEINDUCED PSYCHOTIC DISORDER IN A PSYCHIATRIC HOSPITAL IN GAUTENG, SOUTH AFRICA." Africa Journal of Nursing and Midwifery 16, no. 1 (September 10, 2016): 75–88. http://dx.doi.org/10.25159/2520-5293/1489.
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This study explored the factors contributing to relapse of mental health care users (MHCUs) treated for substance-induced psychotic disorder in a public psychiatric hospital in Gauteng, South Africa. A qualitative, explorative, descriptive and contextual research design was followed. The study was conducted at the outpatient department of the hospital. Participants were selected purposefully from MHCUs visiting the outpatient department for follow-up. Ten semistructured interviews were used to collect data until data saturation occurred. The transcribed interviews and field notes were analysed using Tesch’s method of qualitative data analysis. The researcher and an independent coder reached consensus on the categories, sub-categories and themes. Trustworthiness was ensured through application of the strategies of dependability, transferability, conformability, credibility and authenticity. The findings explicated the factors contributing to relapse of MHCUs treated for substanceinduced psychotic disorder in a psychiatric hospital. These factors included psychological, physical and social factors. Recommendations were provided for psychiatric nurses in terms of therapeutic programme planning and involvement of the community and family in the management of MHCUs treated for substance-induced psychotic disorder.
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Burgess, Naomi, and Deborah Chen. "OP160 Enhancing Innovation Through HTA: Experience From South Australia." International Journal of Technology Assessment in Health Care 34, S1 (2018): 58. http://dx.doi.org/10.1017/s0266462318001666.
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Introduction:A statewide health technology assessment (HTA) program was implemented to increase equity of access and support robust assessment of technologies, with a focus on those that are high-cost, high-risk, or have state-wide impact.Methods:Local hospital networks and clinicians refer technologies to the South Australia Policy Advisory Committee on Technology (SAPACT) for assessment. Independently produced, comprehensive HTA reports are developed using internationally recognized evidence and critical appraisal methodologies. Clinical and economic systematic analyses are utilized, with extensive clinical consultation, to develop recommendations for new technologies and their role in models of care. Feasibility of adoption and local implementation are considered, including existing service delivery and appropriate training and credentialing. For approved technologies, SAPACT may also develop audit criteria and seek implementation reports on clinical outcomes.Results:The HTA framework has been successfully adopted across South Australia Health, increasing the incorporation of evidence-based decision making in the use of high-cost and high-risk health technologies. Over 35 evidence evaluations for high-risk and high-cost health technologies have been conducted for a broad range of treatment interventions. SAPACT develops and utilizes HTA decision-making criteria for transparency of Committee considerations. The program recommends adoption or rejection of technologies, or it may request a re-submission due to safety concerns or a lack of proven effectiveness. SAPACT has also granted temporary approval through adoption under clinical evaluation to inform investment decisions. A key component is working with clinicians to define specific treatment criteria and patient selection. SAPACT continues to strengthen relationships with all stakeholders, increase patient input through the development of public summary documents for technologies, and improve monitoring and reporting of clinical outcomes.Conclusions:The HTA program has been very productive and positively received. The success of the program is underpinned by its engagement with clinicians, hospital networks, and consumers. The completion of SAPACT HTA reviews and the publication of the SAPACT decision-making criteria have increased the credibility of decisions, supporting enhancements in patient care and cost efficiency for the state government.
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Orrell, Martin W., and Sonia Johnson. "Three psychiatric day centres in a London borough." Psychiatric Bulletin 16, no. 9 (September 1992): 540–42. http://dx.doi.org/10.1192/pb.16.9.540.
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Research on day care has tended to focus on the day hospitals rather than day centres. A substantial body of work has evaluated the success of the day hospital as an alternative to the acute admission ward (Herz et al, 1971; Creed et al, 1989). But many day hospitals appear to have taken on long-term supports, the role envisaged for the day centres, as their principal function, rather than short-term treatment (Pryce, 1982; McGrath & Tantam, 1987): for example, Pryce draws attention to the accumulation of long-stay psychiatric day patients in a day hospital in South Glamorgan, where 67% of patients have been attending for between two and 17 years.
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Goldsbury, David E., Eleonora Feletto, Marianne F. Weber, Philip Haywood, Alison Pearce, Jie-Bin Lew, Joachim Worthington, et al. "Health system costs and days in hospital for colorectal cancer patients in New South Wales, Australia." PLOS ONE 16, no. 11 (November 29, 2021): e0260088. http://dx.doi.org/10.1371/journal.pone.0260088.
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Introduction Colorectal cancer (CRC) care costs the Australian healthcare system more than any other cancer. We estimated costs and days in hospital for CRC cases, stratified by site (colon/rectal cancer) and disease stage, to inform detailed analyses of CRC-related healthcare. Methods Incident CRC patients were identified using the Australian 45 and Up Study cohort linked with cancer registry records. We analysed linked hospital admission records, emergency department records, and reimbursement records for government-subsidised medical services and prescription medicines. Cases’ health system costs (2020 Australian dollars) and hospital days were compared with those for cancer-free controls (matched by age, sex, geography, smoking) to estimate excess resources by phase of care, analysed by sociodemographic, health, and disease characteristics. Results 1200 colon and 546 rectal cancer cases were diagnosed 2006–2013, and followed up to June 2016. Eighty-nine percent of cases had surgery, chemotherapy or radiotherapy, and excess costs were predominantly for hospitalisations. Initial phase (12 months post-diagnosis) mean excess health system costs were $50,434 for colon and $60,877 for rectal cancer cases, with means of 16 and 18.5 excess hospital days, respectively. The annual continuing mean excess costs were $6,779 (colon) and $8,336 (rectal), with a mean of 2 excess hospital days each. Resources utilised (costs and days) in these phases increased with more advanced disease, comorbidities, and younger age. Mean excess costs in the year before death were $74,952 (colon) and $67,733 (rectal), with means of 34 and 30 excess hospital days, respectively–resources utilised were similar across all characteristics, apart from lower costs for cases aged ≥75 at diagnosis. Conclusions Health system costs and hospital utilisation for CRC care are greater for people with more advanced disease. These findings provide a benchmark, and will help inform future cost-effectiveness analyses of potential approaches to CRC screening and treatment.
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Tan, Owen, Deborah J. Schofield, and Rupendra Shrestha. "An Analysis of Hospital Costs for Childhood Cancer Care." Journal of the National Comprehensive Cancer Network 20, no. 2 (February 2022): 126–35. http://dx.doi.org/10.6004/jnccn.2020.7802.
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Background: This study used a linked dataset consisting of all childhood cancers recorded over the course of 10 years in New South Wales (NSW), Australia, to evaluate the hospital and emergency department costs (from a payer perspective) and resources used by patients with childhood cancer. We also analyzed determinants responsible for high-frequency hospital admissions, hospital length of stay (LoS), and hospital costs. Methods: We analyzed linked data at the individual patient level for a retrospective cohort of 2,966 patients with cancer aged <18 years with a diagnosis date between 2001 and 2012 from the NSW Central Cancer Registry, Australia. We reported costs and use of hospitalization and emergency department presentation 1 year before the date of diagnosis, 1 year after diagnosis, and 2 to 5 years after diagnosis. We also examined the association between cancer types and hospital admission and hospital costs from the payer perspective. Patient characteristics associated with the frequency of hospital admissions, hospital LoS, and hospital costs were also determined using a generalized linear model. Results: Most hospital admission costs occurred in the first year after diagnosis, accounting for >70% of hospital costs within 5 years after diagnosis. The estimated median annual cost of hospitalization in the first year after diagnosis was A$88,964 (interquartile range [IQR], A$34,399–A$163,968) for patients diagnosed at age 0 to 14 years and A$23,384 (IQR, A$5,585–A$91,565) for those diagnosed at age 15 to 17 years. Higher frequency of hospital admissions, hospital LoS, and hospital costs were significantly associated with younger age at cancer diagnosis, cancer metastases, and living in remote/disadvantaged socioeconomic areas. Conclusions: Our study represents one of the first in Australia to include detailed hospitalization cost information for all childhood cancer cases. This study highlights the high hospital use by pediatric patients and the importance of early diagnosis. Our findings also demonstrate the health inequities experienced by patients from remote areas and the lowest socioeconomic areas.
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Nagarajan, Padmavathi, Priyadersini Moummourtty, RaviPhilip Rajkumar, and Charanya Kaliamoorthy. "Rehabilitation needs of patients with schizophrenia attending the general hospital psychiatric unit of a tertiary care hospital in South India." Industrial Psychiatry Journal 29, no. 2 (2020): 329. http://dx.doi.org/10.4103/ipj.ipj_180_20.
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Mukai, Helena Ayako, Marli de Carvalho Jericó, and Márcia Galan Perroca. "Care needs and workload required by institutionalised psychiatric patients." Revista Latino-Americana de Enfermagem 21, no. 1 (February 2013): 340–47. http://dx.doi.org/10.1590/s0104-11692013000100008.
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OBJECTIVES: This descriptive study used a quantitative approach to assess the nursing care needs of patients with mental disorders, the mean number of care hours these patients were provided and the workload these patients require nursing team. METHODS: The research was conducted in a public neuropsychiatric hospital located in south eastern Brazil in 2010 and included 105 patients as subjects. A patient classification tool was applied to characterise care profiles. Statistical analysis was performed using principal component analysis and analysis of variance. RESULTS: Patients were predominantly in the low care category (73.3%). The mean care hours ranged from 0.57 to 0.88 for nurses and 1.97 to 3.16 for nursing assistants, and the workload ranged from 119.6 to 183 hours . CONCLUSIONS: The present study showed that the care needs of most patients were at a low level of dependency and that most patients did not need to be institutionalised. Furthermore, it was found that the care hours provided by the nursing staff were not sufficient to meet the care needs of the patients.