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Epidemiol Psychiatr Sci. 2011 Jun;20(2):181-92.

Needs-oriented discharge planning for high utilisers of psychiatric services: multicentre randomised controlled trial.

Author information

1
Department of Psychiatry II, Ulm University, Günzburg, Germany. bernd.puschner@bkh-guenzburg.de

Abstract

AIMS:

Attempts to reduce high utilisation of mental health inpatient care by targeting the critical time of hospital discharge are rare. In this study, we test the effect of a needs-oriented discharge planning intervention on number and duration of psychiatric inpatient treatment episodes (primary), as well as on outpatient service use, needs, psychopathology, depression and quality of life (secondary).

METHODS:

Four hundred and ninety-one adults with a defined high utilisation of mental health care gave informed consent to participate in a multicentre RCT carried out at five psychiatric hospitals in Germany (Düsseldorf, Greifswald, Regensburg, Ravensburg and Günzburg). Subjects allocated to the intervention group were offered a manualised needs-led discharge planning and monitoring intervention with two intertwined sessions administered at hospital discharge and 3 months thereafter. Outcomes were assessed at four measurement points during a period of 18 months following discharge.

RESULTS:

Intention-to-treat analyses showed no effect of the intervention on primary or secondary outcomes.

CONCLUSIONS:

Process evaluation pending, the intervention cannot be recommended for implementation in routine care. Other approaches, e.g. team-based community care, might be more beneficial for people with persistent and severe mental illness.

PMID:
21714365
[Indexed for MEDLINE]
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