In-patient treatment in functional and sectorised care: patient satisfaction and length of stay. (1st February 2018)

• Record Type: Journal Article
• Authors: Bird, V.J.; Giacco, D.; Nicaise, P.; Pfennig, A.; Lasalvia, A.; Welbel, M.; Priebe, S.
• Is Part Of: British journal of psychiatry. Volume 212:Number 2(2018)
• Page Start: 81
• Page End: 87
• Publication Date: 2018-02-01
• Subjects: Psychiatry -- Periodicals; Psychology, Pathological -- Periodicals; 616.89005
• DOI: 10.1192/bjp.2017.20
• Languages: English
• ISSNs: 0007-1250

Abstract

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. Declarations of interest: None.