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In-patient treatment in functional and sectorised care : patient satisfaction and length of stay
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Bird, V.J., Giacco, Domenico, Nicaise, P., Pfennig, A., Lasalvia, A., Welbel, M. and Priebe, S. (2018) In-patient treatment in functional and sectorised care : patient satisfaction and length of stay. The British Journal of Psychiatry, 212 (2). pp. 81-87. doi:10.1192/bjp.2017.20
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Official URL: http://dx.doi.org/10.1192/bjp.2017.20
Abstract
Background
Debate exists as to whether functional care, in which different psychiatrists are responsible for in- and out-patient care, leads to better in-patient treatment as compared with sectorised care, in which the same psychiatrist is responsible for care across settings.
Aims
To compare patient satisfaction with in-patient treatment and length of stay in functional and sectorised care.
Method
Patients with an ICD-10 diagnosis of psychotic, affective or anxiety/somatoform disorders consecutively admitted to an adult acute psychiatric ward in 23 hospitals across 11 National Health Service trusts in England were recruited. Patient satisfaction with in-patient care and length of stay (LoS) were compared (trial registration ISRCTN40256812).
Results
In total, 2709 patients were included, of which 1612 received functional and 1097 sectorised care. Patient satisfaction was significantly higher in sectorised care (β = 0.54, 95% CI 0.35–0.73, P<0.001). This difference remained significant when adjusting for locality and patient characteristics. LoS was 6.9 days shorter for patients in sectorised care (β = −6.89, 95% CI –11.76 to −2.02, P<0.001), but this difference did not remain significant when adjusting for clustering by hospital (β = −4.89, 95% CI –13.34 to 3.56, P = 0.26).
Conclusions
This is the first robust evidence that patient satisfaction with in-patient treatment is higher in sectorised care, whereas findings for LoS are less conclusive. If patient satisfaction is seen as a key criterion, sectorised care seems preferable.
| Item Type: | Journal Article | ||||
|---|---|---|---|---|---|
| Divisions: | Faculty of Medicine > Warwick Medical School > Health Sciences Faculty of Medicine > Warwick Medical School > Health Sciences > Mental Health and Wellbeing Faculty of Medicine > Warwick Medical School |
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| Journal or Publication Title: | The British Journal of Psychiatry | ||||
| Publisher: | Cambridge University Press | ||||
| ISSN: | 0007-1250 | ||||
| Official Date: | 1 February 2018 | ||||
| Dates: |
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| Volume: | 212 | ||||
| Number: | 2 | ||||
| Page Range: | pp. 81-87 | ||||
| DOI: | 10.1192/bjp.2017.20 | ||||
| Status: | Peer Reviewed | ||||
| Publication Status: | Published | ||||
| Access rights to Published version: | Restricted or Subscription Access | ||||
| Related URLs: |
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