Patients with multiple admissions in a psychiatric record linkage system.

Data from the Kingston Psychiatric Record Linkage System are used to examine the patterns of both inpatient and outpatient service utilization by patients with multiple admissions during a three year period compared with a control group with single admissions. The subgroup with drug and alcohol abuse disorders alone or in combination with a major functional disorder is examined in detail. An index of service utilization, which is based on aggregate inpatient stay and outpatient contacts, is calculated for each patient. Those with multiple admissions tend to be young, poorly educated, living alone and diagnosed with a major functional disorder; however, multiple regression analysis shows that other factors, as yet undetermined, contribute significantly to readmission. Among those with a major functional disorder, the subgroup of patients who also have drug and alcohol abuse disorders is particularly prone to multiple admissions. The need for specific services for patients with dual diagnoses is discussed. Early identification of those types of psychiatric patients who are likely to use services extensively is necessary to allow for planning and implementing of more cost-efficient and effective services.