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Predictors of personal continuity of care of patients with severe mental illness: A comparison across five European countries.
- Source :
-
European psychiatry : the journal of the Association of European Psychiatrists [Eur Psychiatry] 2019 Feb; Vol. 56, pp. 69-74. Date of Electronic Publication: 2018 Dec 22. - Publication Year :
- 2019
-
Abstract
- Background: In Europe, at discharge from a psychiatric hospital, patients with severe mental illness may be exposed to one of two main care approaches: personal continuity, where one clinician is responsible for in- and outpatient care, and specialisation, where various clinicians are. Such exposure is decided through patient-clinician agreement or at the organisational level, depending on the country's health system. Since personal continuity would be more suitable for patients with complex psychosocial needs, the aim of this study was to identify predictors of patients' exposure to care approaches in different European countries.<br />Methods: Data were collected on 7302 psychiatric hospitalised patients in 2015 in Germany, Poland, and Belgium (patient-level exposure); and in the UK and Italy (organisational-level exposure). At discharge, patients were exposed to one of the care approaches according to usual practice. Putative predictors of exposure at patients' discharge were assessed in both groups of countries.<br />Results: Socially disadvantaged patients were significantly more exposed to personal continuity. In all countries, the main predictor of exposure was the admission hospital, except in Germany, where having a diagnosis of psychosis and a higher education status were predictors of exposure to personal continuity. In the UK, hospitals practising personal continuity had a more socially disadvantaged patient population.<br />Conclusion: Even in countries where exposure is decided through patient-clinician agreement, it was the admission hospital, not patient characteristics, that predicted exposure to care approaches. Nevertheless, organisational decisions in hospitals tend to expose socially disadvantaged patients to personal continuity.<br /> (Copyright © 2018 Elsevier Masson SAS. All rights reserved.)
- Subjects :
- Adult
Belgium
Europe
Female
Germany
Hospitalization
Hospitals, Psychiatric organization & administration
Humans
Italy
Male
Middle Aged
Patient Discharge statistics & numerical data
Poland
Psychotic Disorders epidemiology
Ambulatory Care statistics & numerical data
Continuity of Patient Care organization & administration
Psychotic Disorders therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1778-3585
- Volume :
- 56
- Database :
- MEDLINE
- Journal :
- European psychiatry : the journal of the Association of European Psychiatrists
- Publication Type :
- Academic Journal
- Accession number :
- 30583254
- Full Text :
- https://doi.org/10.1016/j.eurpsy.2018.12.003