Treatment of Depressed Patients in General Hospitals With Scatter Beds, Cluster Beds, and Psychiatric Units

Records of 725 patients with a primary discharge diagnosis of depression were reviewed at nine general hospitals: three with psychiatric units, three in which patients were treated in beds grouped together on a medical or surgical floor (cluster beds), and three in which patients were treated in beds dispersed among medical and surgical beds (scatter beds). Patients treated in psychiatric units most commonly presented with suicidal or homicidal indicators, most frequently received antidepressants, and had the longest stays. Patients treated in scatter beds tended to present with somatic complaints, were least likely to receive antidepressants, and had the shortest hospital stays. Patients treated in cluster beds presented with intermediate symptoms and bad stays of intermediate duration. Although dangerous or psychotic patients may be most appropriately treated in units, other patient groups may be safely and effectively treated at lower cost in less specialized inpatient settings.