Admission Volume and Quality of Mental Health Care Among Danish Patients With Recently Diagnosed Schizophrenia
Abstract
Objective:
Methods:
Results:
Conclusions:
Methods
The Danish Schizophrenia Registry
Care process | Definition |
---|---|
Assessment of psychopathology by a specialist in psychiatry | Indication of whether the patient has been assessed for psychopathological characteristics by a specialist in psychiatry to ensure a valid diagnosis |
Assessment of psychopathology with a diagnostic interview | Indication of whether the patient received a diagnostic interview with an established interview instrument, such as Schedules for Clinical Assessment in Neuropsychiatry or the Operational Criteria Checklist for Psychosis |
Assessment of cognitive function | Indication of whether the patient was administered a cognitive test by a psychologist |
Assessment by a social worker | Indication of whether the patient was assessed by a social worker for need of social support, such as financial help to purchase medicine, help with changing housing, or application for disability benefits |
Antipsychotic medication treatment | Indication of whether the patient was prescribed antipsychotic medication |
Staff contact with relatives | Indication of whether the patient’s relatives had contact with the staff |
Psychoeducation | Indication of whether the patient received psychoeducation |
Professional support | Indication of whether a patient with a Global Assessment of Functioning score ≤30 was referred to postdischarge professional support in the patient’s own home, residential facility, or care home |
Psychiatric aftercare | Indication of whether the patient was referred to psychiatric aftercare, including outpatient treatment or contact with a general practice or a private specialist after discharge |
Suicide risk assessment | Indication of whether the patient was assessed for suicide risk in the week before discharge, including an evaluation of depressive symptoms |
Study Population
Psychiatric Hospital Units
Statistical Analyses
Results
Characteristic | Low volume | Medium volume | High volume | Very high volume | ||||
---|---|---|---|---|---|---|---|---|
N | % | N | % | N | % | N | % | |
Gender | ||||||||
Women | 301 | 38 | 378 | 43 | 394 | 42 | 417 | 43 |
Men | 489 | 62 | 494 | 57 | 533 | 58 | 549 | 57 |
Age | ||||||||
18–29 | 446 | 56 | 480 | 55 | 461 | 50 | 532 | 55 |
30–39 | 180 | 23 | 197 | 23 | 218 | 23 | 217 | 22 |
40–49 | 83 | 11 | 114 | 13 | 135 | 15 | 109 | 11 |
50–59 | 55 | 7 | 48 | 5 | 69 | 7 | 54 | 6 |
≥60 | 26 | 3 | 33 | 4 | 44 | 5 | 54 | 6 |
Alcohol abuse | ||||||||
Yes | 175 | 22 | 233 | 27 | 199 | 21 | 172 | 18 |
Unknown | 63 | 8 | 58 | 7 | 51 | 6 | 45 | 5 |
Illicit drug abuse | ||||||||
Yes | 62 | 8 | 58 | 7 | 62 | 7 | 55 | 6 |
Unknown | 121 | 15 | 119 | 14 | 106 | 11 | 80 | 8 |
Benzodiazepine abuse | ||||||||
Yes | 57 | 7 | 69 | 8 | 37 | 4 | 43 | 4 |
Unknown | 98 | 12 | 81 | 9 | 92 | 10 | 63 | 7 |
Cannabis abuse | ||||||||
Yes | 240 | 30 | 264 | 30 | 246 | 27 | 249 | 26 |
Unknown | 56 | 7 | 54 | 6 | 66 | 7 | 42 | 4 |
Global Assessment of Functioning score | ||||||||
0–29 | 72 | 9 | 85 | 10 | 50 | 5 | 54 | 6 |
30–39 | 202 | 25 | 282 | 32 | 215 | 23 | 358 | 37 |
40–49 | 190 | 24 | 214 | 25 | 261 | 28 | 296 | 31 |
50–100 | 211 | 27 | 191 | 22 | 312 | 34 | 166 | 17 |
Unknown | 115 | 15 | 100 | 11 | 89 | 10 | 92 | 9 |
Relevant processes of care received (%) | ||||||||
0–19 | 8 | 1 | 6 | 1 | 10 | 1 | 6 | 1 |
20–39 | 88 | 11 | 64 | 7 | 78 | 8 | 58 | 6 |
40–59 | 204 | 26 | 168 | 19 | 209 | 23 | 170 | 17 |
60–79 | 288 | 36 | 368 | 42 | 362 | 39 | 385 | 40 |
80–100 | 202 | 26 | 266 | 31 | 268 | 29 | 347 | 36 |
Admission volumea | Total admissions | Received high-quality care (%)b | RR | 95% CI |
---|---|---|---|---|
Medium | 872 | 31 | 1.19 | .93–1.53 |
High | 927 | 29 | 1.13 | .79–1.62 |
Very high | 966 | 36 | 1.40 | 1.03–1.91 |
Care process | Low volume | Medium volume | High volume | Very high volume | ||||
---|---|---|---|---|---|---|---|---|
N | % | N | % | N | % | N | % | |
Assessment of psychopathology by a specialist in psychiatry | 790 | 100 | 872 | 100 | 927 | 100 | 966 | 100 |
No | 69 | 9 | 101 | 12 | 69 | 8 | 45 | 5 |
Yes | 654 | 83 | 710 | 81 | 780 | 84 | 889 | 92 |
Unknown | 67 | 8 | 61 | 7 | 78 | 8 | 32 | 3 |
Assessment of psychopathology with a diagnostic interview | 705 | 100 | 820 | 100 | 848 | 100 | 847 | 100 |
No | 258 | 37 | 246 | 30 | 293 | 34 | 320 | 38 |
Yes | 239 | 34 | 362 | 44 | 295 | 35 | 352 | 41 |
Unknown | 208 | 29 | 212 | 26 | 260 | 31 | 175 | 21 |
Assessment of cognitive function | 790 | 100 | 872 | 100 | 927 | 100 | 966 | 100 |
No | 472 | 60 | 531 | 61 | 476 | 51 | 545 | 56 |
Yes | 215 | 27 | 216 | 25 | 329 | 36 | 338 | 35 |
Unknown | 103 | 13 | 125 | 14 | 122 | 13 | 83 | 9 |
Assessment by a social worker | 790 | 100 | 872 | 100 | 927 | 100 | 966 | 100 |
No | 130 | 17 | 129 | 15 | 132 | 14 | 126 | 13 |
Yes | 586 | 74 | 655 | 75 | 696 | 75 | 783 | 81 |
Unknown | 74 | 9 | 88 | 10 | 99 | 11 | 57 | 6 |
Antipsychotic medication treatment | 790 | 100 | 872 | 100 | 927 | 100 | 966 | 100 |
No | 31 | 4 | 28 | 3 | 39 | 4 | 47 | 5 |
Yes | 718 | 91 | 810 | 93 | 831 | 90 | 882 | 91 |
Unknown | 41 | 5 | 34 | 4 | 57 | 6 | 37 | 4 |
Staff contact with relatives | 790 | 100 | 872 | 100 | 927 | 100 | 966 | 100 |
No | 147 | 19 | 104 | 12 | 212 | 23 | 214 | 22 |
Yes | 511 | 65 | 626 | 72 | 577 | 62 | 622 | 64 |
Not relevant | 90 | 11 | 104 | 12 | 100 | 11 | 92 | 10 |
Unknown | 42 | 5 | 38 | 4 | 38 | 4 | 38 | 4 |
Psychoeducation | 790 | 100 | 872 | 100 | 927 | 100 | 966 | 100 |
No | 211 | 27 | 150 | 17 | 173 | 19 | 159 | 17 |
Yes | 517 | 65 | 650 | 75 | 675 | 73 | 757 | 78 |
Not relevant | 20 | 3 | 25 | 3 | 18 | 2 | 7 | 1 |
Unknown | 42 | 5 | 47 | 5 | 61 | 6 | 43 | 4 |
Professional support | 113 | 100 | 130 | 100 | 79 | 100 | 80 | 100 |
No | 11 | 10 | 16 | 12 | 12 | 15 | 15 | 19 |
Yes | 78 | 69 | 101 | 78 | 41 | 52 | 47 | 59 |
Unknown | 24 | 21 | 13 | 10 | 26 | 33 | 18 | 22 |
Psychiatric aftercare | 705 | 100 | 820 | 100 | 848 | 100 | 847 | 100 |
No | 51 | 7 | 63 | 8 | 54 | 6 | 61 | 7 |
Yes | 534 | 76 | 650 | 79 | 644 | 76 | 660 | 78 |
Unknown | 120 | 17 | 107 | 13 | 150 | 18 | 126 | 15 |
Suicide risk assessment | 705 | 100 | 820 | 100 | 848 | 100 | 847 | 100 |
No | 89 | 13 | 94 | 12 | 46 | 5 | 76 | 9 |
Yes | 410 | 58 | 602 | 73 | 657 | 78 | 641 | 76 |
Unknown | 206 | 29 | 124 | 15 | 145 | 17 | 130 | 15 |
Care process and admission volume | Total admissions | Percentage receiving the care process | RR | 95% CI |
---|---|---|---|---|
Assessment of psychopathology by a specialist in psychiatry | ||||
Medium | 811 | 88 | .97 | .92–1.02 |
High | 849 | 92 | 1.02 | .97–1.07 |
Very high | 934 | 95 | 1.05 | 1.01–1.10 |
Assessment of psychopathology with a diagnostic interview | ||||
Medium | 608 | 60 | 1.24 | .99–1.55 |
High | 588 | 50 | 1.04 | .78–1.39 |
Very high | 672 | 52 | 1.09 | .76–1.56 |
Assessment of cognitive function | ||||
Medium | 747 | 29 | .92 | .65–1.31 |
High | 805 | 41 | 1.31 | .95–1.80 |
Very high | 883 | 38 | 1.22 | .96–1.55 |
Assessment by a social worker | ||||
Medium | 784 | 84 | 1.02 | .94–1.10 |
High | 828 | 84 | 1.03 | .95–1.11 |
Very high | 909 | 86 | 1.05 | .97–1.14 |
Antipsychotic medication treatment | ||||
Medium | 838 | 97 | 1.01 | .99–1.03 |
High | 870 | 96 | .99 | .97–1.02 |
Very high | 929 | 95 | .99 | .97–1.01 |
Staff contact with relatives | ||||
Medium | 730 | 86 | 1.10 | 1.03–1.19 |
High | 789 | 73 | .94 | .87–1.02 |
Very high | 836 | 74 | .96 | .88–1.04 |
Psychoeducation | ||||
Medium | 800 | 81 | 1.14 | 1.03–1.26 |
High | 848 | 80 | 1.12 | 1.02–1.23 |
Very high | 916 | 83 | 1.16 | 1.05–1.28 |
Professional support | ||||
Medium | 117 | 86 | .98 | .88–1.11 |
High | 53 | 77 | .88 | .73–1.06 |
Very high | 62 | 76 | .86 | .73–1.03 |
Psychiatric aftercare | ||||
Medium | 713 | 91 | .99 | .95–1.05 |
High | 698 | 92 | 1.01 | .96–1.06 |
Very high | 721 | 92 | 1.00 | .95–1.06 |
Suicide risk assessment | ||||
Medium | 696 | 86 | 1.05 | .98–1.13 |
High | 703 | 93 | 1.14 | 1.07–1.21 |
Very high | 717 | 89 | 1.09 | .99–1.19 |
Discussion
Strengths and Limitations
Comparison With Other Studies
Conclusions
References
Information & Authors
Information
Published In
![Go to Psychiatric Services](/cms/10.1176/ps.2016.67.issue-5/asset/18d36b81-9018-36b8-c901-d36b81c9018d/ps.2016.67.issue-5.largecover.jpg)
Cover: Assinibone hand drum, by Werner Forman. From the Plains Indian Museum, BBHC, Cody, Wyoming. Photo credit: HIP/Art Resource, New York City.
History
Authors
Competing Interests
Metrics & Citations
Metrics
Citations
Export Citations
If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Simply select your manager software from the list below and click Download.
For more information or tips please see 'Downloading to a citation manager' in the Help menu.
There are no citations for this item
View Options
View options
PDF/ePub
View PDF/ePubGet Access
Login options
Already a subscriber? Access your subscription through your login credentials or your institution for full access to this article.
Personal login Institutional Login Open Athens loginNot a subscriber?
PsychiatryOnline subscription options offer access to the DSM-5-TR® library, books, journals, CME, and patient resources. This all-in-one virtual library provides psychiatrists and mental health professionals with key resources for diagnosis, treatment, research, and professional development.
Need more help? PsychiatryOnline Customer Service may be reached by emailing [email protected] or by calling 800-368-5777 (in the U.S.) or 703-907-7322 (outside the U.S.).