Patient-controlled Admissions in Inpatient Mental Health Services

Summary

Patient-controlled admissions are short self-referred inpatient admissions in mental health services without approval by clinicians. The intention is to reduce a high use of inpatient care. Patients are signing a contract for a specified period with stays limited to a maximum number of days and with a minimum number of weeks between stays. The few studies so far show tendencies to a possible effect, but additional studies are needed.

The aims of the study are to describe the use and experiences of patient-controlled admissions, compare the use of inpatient admissions and inpatient days during the 24 months before and after baseline, and to identify subgroups who may benefit from the model.

The study is a pre-post prospective intervention study where the use of inpatient admissions in the contract period is compared to a similar period before baseline so that the patients are their own controls. The study is done in inpatient wards in four community mental health centers of Akershus University Hospital, Norway.

The study aims to recruit 120 patients. The eligible patients have a severe mental illness, high use of inpatient mental health care the last two years and are expected to benefit from patient-controlled admissions. The patients will be followed for 24 months from baseline.

Data at baseline includes socio-demographics, diagnoses, type and severity of psychiatric problems, and use of alcohol and drugs. Data on admissions and experience of these are collected during the contract period, Data on patients' and relatives' experience of the model are collected at the end of the period. Data on total inpatient admissions/stays during the 24 months before and after baseline are extracted from the hospital patient records.

Data analyses will include descriptive statistics on the sample and the use of inpatient care, testing of differences of inpatient care between 24 months before and after baseline, multiple regression of associations between baseline characteristics and the use of inpatient care, and analyses to identify subgroups who benefit from the model.

The study protocol in Norwegian was approved by the Regional Committee on Medical and Health Research Ethics in Norway South East 29 April 2011 (reg.no. 2011/790).

The inclusion period was 2011-2012. Data collection were done 2011-2014. Data extraction from the patient records was done 2015-2016. Quality control and organization of data was done 2017-2018. Data analysis will start in August 2018.

Conditions

• Psychoses
• Affective Disorder

Interventions

OTHER

Patient-controlled admission

The patients with a contract for patient-controlled admissions may refer themselves to short inpatient stays when they feel the need, without needing an approval from a clinician. They will be accepted for admission if a patient-controlled bed is available in the ward. Patient-controlled admissions are limited to a length of 5 days and at least three weeks between such stays.

Sponsors & Collaborators

• University Hospital, Akershus

  lead OTHER

Study Design

Allocation

NA

Purpose

HEALTH_SERVICES_RESEARCH

Masking

NONE

Model

SINGLE_GROUP

Eligibility

Min Age

18 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2011-04-01

Primary Completion

2012-12-31

Completion

2012-12-31