Similarities and differences in people accessing prevention and recovery care services and inpatient units in Victoria, Australia.


Journal

BMC health services research
ISSN: 1472-6963
Titre abrégé: BMC Health Serv Res
Pays: England
ID NLM: 101088677

Informations de publication

Date de publication:
16 Jun 2020
Historique:
received: 19 08 2018
accepted: 04 06 2020
entrez: 18 6 2020
pubmed: 18 6 2020
medline: 15 12 2020
Statut: epublish

Résumé

There is an emerging international literature demonstrating clinical and cost-effectiveness of sub-acute residential mental health services. To date, however, there is limited information on the profile of consumers accessing these models of care. This study aimed to understand the profile of the population served by adult sub-acute residential mental health services in Victoria, Australia (known as Prevention and Recovery Care; PARC) and to compare PARC service consumers with consumers admitted to psychiatric inpatient units within public hospitals. Using 5 years (2012-2016) of a state-wide database of routinely collected individual level mental health service data, we describe the socio-demographic and clinical profile of PARC service consumers compared to consumers of psychiatric inpatient units including for primary diagnosis and illness severity. Using admissions as the unit of analysis, we identify the characteristics that distinguish PARC service admissions from psychiatric inpatient admissions. We also examine and compare length of stay for the different admission types. We analysed 78,264 admissions representing 34,906 individuals. The profile of PARC service consumers differed from those admitted to inpatient units including for sex, age, diagnosis and illness severity. The odds of an admission being to a PARC service was associated with several socio-demographic and clinical characteristics. Being male or in the youngest age grouping (< 20 years) significantly reduced the odds of admission to PARC services. The presence of primary diagnoses of schizophrenia and related disorders, mood, anxiety or personality disorders, all significantly increased the odds of admission to PARC services. Predictors of length of stay were consistent across PARC and inpatient admission types. Our findings suggest PARC services may serve an overlapping but distinguishably different consumer group than inpatient psychiatric units. Future research on sub-acute mental health services should be cognizant of these consumer differences, particularly when assessing the long-term effectiveness of this service option.

Sections du résumé

BACKGROUND BACKGROUND
There is an emerging international literature demonstrating clinical and cost-effectiveness of sub-acute residential mental health services. To date, however, there is limited information on the profile of consumers accessing these models of care. This study aimed to understand the profile of the population served by adult sub-acute residential mental health services in Victoria, Australia (known as Prevention and Recovery Care; PARC) and to compare PARC service consumers with consumers admitted to psychiatric inpatient units within public hospitals.
METHOD METHODS
Using 5 years (2012-2016) of a state-wide database of routinely collected individual level mental health service data, we describe the socio-demographic and clinical profile of PARC service consumers compared to consumers of psychiatric inpatient units including for primary diagnosis and illness severity. Using admissions as the unit of analysis, we identify the characteristics that distinguish PARC service admissions from psychiatric inpatient admissions. We also examine and compare length of stay for the different admission types.
RESULTS RESULTS
We analysed 78,264 admissions representing 34,906 individuals. The profile of PARC service consumers differed from those admitted to inpatient units including for sex, age, diagnosis and illness severity. The odds of an admission being to a PARC service was associated with several socio-demographic and clinical characteristics. Being male or in the youngest age grouping (< 20 years) significantly reduced the odds of admission to PARC services. The presence of primary diagnoses of schizophrenia and related disorders, mood, anxiety or personality disorders, all significantly increased the odds of admission to PARC services. Predictors of length of stay were consistent across PARC and inpatient admission types.
CONCLUSIONS CONCLUSIONS
Our findings suggest PARC services may serve an overlapping but distinguishably different consumer group than inpatient psychiatric units. Future research on sub-acute mental health services should be cognizant of these consumer differences, particularly when assessing the long-term effectiveness of this service option.

Identifiants

pubmed: 32546224
doi: 10.1186/s12913-020-05402-3
pii: 10.1186/s12913-020-05402-3
pmc: PMC7296697
doi:

Types de publication

Comparative Study Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

542

Subventions

Organisme : National Health and Medical Research Council
ID : 1115907

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Auteurs

Georgina Sutherland (G)

Melbourne School of Population and Global Health, University of Melbourne, Parkville, VIC, Australia. georgina.sutherland@unimelb.edu.au.

Carol Harvey (C)

Psychosocial Research Centre, Department of Psychiatry, University of Melbourne, Parkville, VIC, Australia.

Holly Tibble (H)

Usher Institute, University of Edinburgh, Edinburgh, Scotland.

Matthew J Spittal (MJ)

Melbourne School of Population and Global Health, University of Melbourne, Parkville, VIC, Australia.

John Farhall (J)

Department of Psychology and Counselling, La Trobe University, Bundoora, VIC, Australia.
NorthWestern Mental Health, Parkville, VIC, Australia.

Justine Fletcher (J)

Melbourne School of Population and Global Health, University of Melbourne, Parkville, VIC, Australia.

Graham Meadows (G)

Southern Synergy, Faculty of Medicine, Nursing and Health Science, Monash University, Clayton, VIC, Australia.

J Richard Newton (JR)

Dept of Psychiatry, Monash University, Peninsula Mental Health Service, Frankston, VIC, Australia.

Ruth Vine (R)

NorthWestern Mental Health, Parkville, VIC, Australia.

Lisa Brophy (L)

Melbourne School of Population and Global Health, University of Melbourne, Parkville, VIC, Australia.
School of Allied Health, Human Services and Sport, La Trobe University , Bundoora, VIC, Australia.

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