Impact on continuity of care of decentralized versus partly centralized mental health care in Northern Norway
<strong>Background: </strong>The issue of continuity of care is central in contemporary psychiatric services research. In Norway, inpatient admissions are mainly to take place locally, in a system of small bed-units that represent an alternative to traditional central psychiatric hospita...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Ubiquity Press
2011-12-01
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| Series: | International Journal of Integrated Care |
| Subjects: | |
| Online Access: | http://www.ijic.org/articles/674 |
| _version_ | 1818059584758087680 |
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| author | Lars Henrik Myklebust Reidun Olstad Svein Bjorbekkmo Martin Eisemann Rolf Wynn Knut Sørgaard |
| author_facet | Lars Henrik Myklebust Reidun Olstad Svein Bjorbekkmo Martin Eisemann Rolf Wynn Knut Sørgaard |
| author_sort | Lars Henrik Myklebust |
| collection | DOAJ |
| description | <strong>Background: </strong>The issue of continuity of care is central in contemporary psychiatric services research. In Norway, inpatient admissions are mainly to take place locally, in a system of small bed-units that represent an alternative to traditional central psychiatric hospitals. This type of organization may be advantageous for accessibility and cooperation, but has been given little scientific attention. <strong>Aims: </strong>To study whether inpatients' utilization of outpatient services differ between an area with a decentralized care model in comparison to an adjacent area with a partly centralized model. <strong> </strong> <strong>Method: </strong>The study was based on data from a one-year registered prevalence sample, drawing on routinely sampled data supplemented with data from medical records. Service-utilization for 247 inpatients was analyzed. The results were controlled for diagnosis, demographic variables, type of service system, localization of inpatient admissions, and length of hospitalization.<strong> </strong> <strong>Results</strong>: Most inpatients in the area with the decentralized care model also utilized outpatient consultations, whereas a considerable number of inpatients in the area with a partly centralized model did not enter outpatient care at all. Type of service system, localization of inpatient admission, and length of hospitalization predicted inpatients' utilization of outpatient consultations. The results are discussed in the light of systems integration, particularly management-arrangements and clinical bridging over the transitional phase from inpatient to outpatient care. <strong>Conclusion</strong>: Inpatients' utilization of outpatient services differed between an area with a decentralized care model in comparison to an adjacent area with a partly centralized care model. In the areas studied, extensive decentralization of the psychiatric services positively affected coordination of inpatient and outpatient services for people with severe psychiatric disorders. Small, local-bed units may therefore represent a favourable alternative to traditional central psychiatric hospitals. |
| first_indexed | 2024-12-10T13:18:51Z |
| format | Article |
| id | doaj.art-1b1a0e7903b242d48bae36712ca01dd6 |
| institution | Directory Open Access Journal |
| issn | 1568-4156 |
| language | English |
| last_indexed | 2024-12-10T13:18:51Z |
| publishDate | 2011-12-01 |
| publisher | Ubiquity Press |
| record_format | Article |
| series | International Journal of Integrated Care |
| spelling | doaj.art-1b1a0e7903b242d48bae36712ca01dd62022-12-22T01:47:25ZengUbiquity PressInternational Journal of Integrated Care1568-41562011-12-0111410.5334/ijic.674742Impact on continuity of care of decentralized versus partly centralized mental health care in Northern NorwayLars Henrik Myklebust0Reidun Olstad1Svein Bjorbekkmo2Martin Eisemann3Rolf Wynn4Knut Sørgaard5Psychiatric Research Centre of North NorwayPsychiatric Research Centre of North NorwayNordland Hospital TrustUniversity of TromsøUniversity of TromsøPsychiatric Research Centre of North Norway<strong>Background: </strong>The issue of continuity of care is central in contemporary psychiatric services research. In Norway, inpatient admissions are mainly to take place locally, in a system of small bed-units that represent an alternative to traditional central psychiatric hospitals. This type of organization may be advantageous for accessibility and cooperation, but has been given little scientific attention. <strong>Aims: </strong>To study whether inpatients' utilization of outpatient services differ between an area with a decentralized care model in comparison to an adjacent area with a partly centralized model. <strong> </strong> <strong>Method: </strong>The study was based on data from a one-year registered prevalence sample, drawing on routinely sampled data supplemented with data from medical records. Service-utilization for 247 inpatients was analyzed. The results were controlled for diagnosis, demographic variables, type of service system, localization of inpatient admissions, and length of hospitalization.<strong> </strong> <strong>Results</strong>: Most inpatients in the area with the decentralized care model also utilized outpatient consultations, whereas a considerable number of inpatients in the area with a partly centralized model did not enter outpatient care at all. Type of service system, localization of inpatient admission, and length of hospitalization predicted inpatients' utilization of outpatient consultations. The results are discussed in the light of systems integration, particularly management-arrangements and clinical bridging over the transitional phase from inpatient to outpatient care. <strong>Conclusion</strong>: Inpatients' utilization of outpatient services differed between an area with a decentralized care model in comparison to an adjacent area with a partly centralized care model. In the areas studied, extensive decentralization of the psychiatric services positively affected coordination of inpatient and outpatient services for people with severe psychiatric disorders. Small, local-bed units may therefore represent a favourable alternative to traditional central psychiatric hospitals.http://www.ijic.org/articles/674decentralizationintegrationpsychiatryservice modelshospitalizationoutpatients |
| spellingShingle | Lars Henrik Myklebust Reidun Olstad Svein Bjorbekkmo Martin Eisemann Rolf Wynn Knut Sørgaard Impact on continuity of care of decentralized versus partly centralized mental health care in Northern Norway International Journal of Integrated Care decentralization integration psychiatry service models hospitalization outpatients |
| title | Impact on continuity of care of decentralized versus partly centralized mental health care in Northern Norway |
| title_full | Impact on continuity of care of decentralized versus partly centralized mental health care in Northern Norway |
| title_fullStr | Impact on continuity of care of decentralized versus partly centralized mental health care in Northern Norway |
| title_full_unstemmed | Impact on continuity of care of decentralized versus partly centralized mental health care in Northern Norway |
| title_short | Impact on continuity of care of decentralized versus partly centralized mental health care in Northern Norway |
| title_sort | impact on continuity of care of decentralized versus partly centralized mental health care in northern norway |
| topic | decentralization integration psychiatry service models hospitalization outpatients |
| url | http://www.ijic.org/articles/674 |
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