Conference Proceedings - School of Nursing & Midwifery - Trinity ...

School of Nursing & Midwifery, Trinity College Dublin: 8 th Annual Interdisciplinary Research Conference
Transforming Healthcare Through Research, Education & Technology: 7 th – 9 th November 2007
Conference Proceedings
Kastrup, 1987a; Weissman et al., 1994; Rabinowitz et al., 1995;
Mahendran et al., 2005).
Aims
The aim of this study was to examine re-admissions to Irish
psychiatric units and hospitals and to identify the characteristics of
those who were re-admitted. Secondly, the study attempted to
identify frequent users of the in-patient services as a subgroup of
re-admissions and thirdly, it examined if staffing levels had any
impact on re-admissions to in-patient services.
Method
First admissions to the National Psychiatric In-patient Reporting
System (NPIRS) for those hospitals using a unique patient number
were extracted for 2001 and followed for the five-year period 2001–
2005. In 2001, 22 hospitals out of a total of 51 (43%) used a
unique patient identifier.
Results
Thirty-seven per cent of the sample (1,274/3,473) had one or more
re-admissions during the study period while 7% (246/3,473) of the
sample were frequent users i.e. had four or more re-admissions.
Those who were re-admitted and those who were frequent users
tended to be female, younger and had a diagnosis of depression,
schizophrenia or alcoholic disorders. Lower staff numbers were
associated with more re-admissions, a greater number of frequent
users and a longer length of stay.
Conclusions
Patients with enduring and recurring illnesses, because of the
nature of their illnesses, will require frequent in-patient admissions.
Thus re-admissions will continue to be a feature of in-patient
services regardless of any future expansion in community-based
services. More progress on the treatment of alcoholic disorders on
an outpatient basis needs to be made. The high proportion of
younger persons among those re-admitted and among frequent
users remains a concern and is one which needs to be addressed.
References
Gastal FL, Andreoli SB, Quintana MIS, Gameiro MA, Leite SO,
McGrath J (2000) Predicting the revolving door phenomenon among
patients with schizophrenic, affective disorders and non-organic
psychoses. Rev. Saúde Pública Journal of Public Health, 34(3):
280–85.
Kastrup M (1987a) The use of a psychiatric register in predicting the
outcome “revolving door patient”. A nationwide cohort of first time
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