Similarities and differences in people accessing prevention and recovery care services and inpatient units in Victoria, Australia.
Consumer profile
Mental health service
Residential unit
Routinely collected data
Sub-acute
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
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
542Subventions
Organisme : National Health and Medical Research Council
ID : 1115907
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