| dc.description.abstract | 70 patient referred to hospital were analyzed in order to study the new kind of admission system developed at Keroputas hospital. The decision on admission was made at an admission meeting, where the patient, the family members, the policlinic team and a representative of the potential hospital ward were present. The treatment decision is produced as a result of an open discussion between the participants. The methods included a psychiatric interview at which the ICD-87 diagnosis was defined, BPRS-, HAMD-, MADRS- and Strauss-Carpenter-ratings, the psychological testing, family rating with Olson's Clinical Rating Scale (CRS), rating of the behaviour of the admission team on the basis of a revised version of CRS and analysis of the social network with the Network Analysis Profile scale by Cohen and Sokolovsky. With structured interview forms, the opinions of the referring authority, the admission psychiatrist and the policlinic team were interviewed about the causes of the admission decision. From a population of 70 patients, 28 were chosen for outpatient treatment and 42 for inpatient treatment. The outpatient and the hospital groups were compared both by statistical and qualitative methods. The uncontrolled behaviour of the patient and his/her dangerousness to him/herself or to others were the most important factors of the patient affecting the admission decision. The good communication skills of the family and in generally a good rating at CRS were connected with the decision for outpatient treatment. A lack of mutual interaction within the impoverished social network were the most effective qualities of the social network on the decision to admit. Using factor analysis three factors came out. The co-evolving behaviour of the admission team and the family was the most affective factor, the severity of symptoms was the second and the impoverishment of the social network and the chronicity of the illnes was the third factor. The new admission system decreased hospitalizations by 30 %. Of the different evaluations, the view of the admission team correlated most to the admission decision, secondly the admission psychiatrist and least the view of the referring authority. | en |
