Citation

Caarls PJ, van Schijndel MA, Kromkamp M, Wierdsma AI, Osse RJ, van der Hoeven G, Hoogendijk WJG, van Busschbach JJ. BMC Health Serv. Res. 2019; 19(1): e139.

Affiliation

Erasmus MC, University Medical Center Rotterdam, Department of Psychiatry, s-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands.

Copyright

(Copyright © 2019, Holtzbrinck Springer Nature Publishing Group - BMC)

DOI

10.1186/s12913-019-3967-7

PMID

30819164

Abstract

BACKGROUND: The study aims were: to estimate the proportion of patients with an indication for admission to a new high acuity Medical Psychiatric Unit (MPU), to explore the reasons for MPU-admission according to different health disciplines, and to check for differences in patient characteristics. The results of this study are to be utilized in the proposed establishment of a high-acuity MPU in a University Medical Center. Such a unit currently does not exist at Erasmus MC.

METHODS: Hospital in-patients were included if they received psychiatric consultation from the Psychiatric Consultative Service (PCS). As part of the study protocol, psychiatrists, other medical specialists, and nurses determined the need for admission to the proposed MPU. Patient groups were compared with respect to diagnoses, socio-demographic characteristics and patient routing.

RESULTS: One hundred and fifty-one patients were included, 43% had an indication for MPU-admission, for the other patients PCS involvement was sufficient. There was agreement on suicide attempts as a reason for MPU-admission. For psychiatrists, the need for further diagnostic evaluation was a common reason for MPU admission, while other medical specialists more often emphasized the need for safety measures. Patients with an unplanned hospital admission had a higher chance of MPU eligibility (OR = 2.72, 95% CI 1.10-6.70). The main psychiatric diagnoses of MPU-eligible patients were organic disorders (including delirium), mood disorders, and disorders related to substance abuse. The most common diagnoses found were similar to those in previous research on MPU populations.

CONCLUSION: Different medical disciplines have different views on the advantages of MPUs, while all see the need for such facilities. The proposed MPU should be able to accommodate patients directly from the Emergency Unit, and the MPU should provide specialized diagnostic care in an extra safe environment.

Language: en

Keywords

Collaborative care; Comorbidity; Hospital organization; Medical psychiatry unit; Patient admission