Nicholas A Keks1, Judy Hope2, William Pring3, Saji Damodaran4, Shashjit Varma4, Voula Adamopoulos5. 1. Professor, Monash University, and Director, Centre for Mental Health Education and Research at Delmont Private Hospital, Monash Medical Centre, Melbourne, VIC, Australia. 2. Senior Lecturer, Monash University, and Deputy Director, Centre for Mental Health Education and Research at Delmont Private Hospital, Melbourne, VIC, Australia. 3. Fellow and Senior Lecturer, Monash University, and Centre for Mental Health Education and Research at Delmont Private Hospital, Melbourne, VIC, Australia. 4. Associate Professor, Monash University, and Centre for Mental Health Education and Research at Delmont Private Hospital, Melbourne, VIC, Australia. 5. Research Psychologist, Centre for Mental Health Education and Research at Delmont Private Hospital, Melbourne, VIC, Australia.
Abstract
OBJECTIVES: : To perform a clinical and risk audit of private hospital inpatients staying in hospital at least 21 days. METHODS: : Of 492 admissions for ≥21 days in 2016, 40 were randomly selected for audit. Characteristics, illness severity and course using the Clinical Global Impression severity (CGI-S) subscale and improvement (CGI-I) subscale, and clinical risk profiles were ascertained at admission, day 15 and discharge by two psychiatrists. RESULTS: : The cases were 65% female, age 50.0±16.2 years (range 24-86), 43% in relationships, and 28% on disability support. The length of stay was 29±7 days. On admission 88% were severely or markedly ill on the CGI-S subscale. Thirty-nine of 40 cases had ≥3 psychiatric diagnoses: 93% depression, 48% bipolar, 15% schizophrenia. High risk was present in suicide risk (48%), illness-induced dysfunction risk (78%) and physical risk (28%). By day 15, 63% were not improved or marginally worse. Suicide ratings were unimproved. By the time of discharge, illness severity and risk ratings were significantly reduced. CONCLUSION: : Private hospital inpatients staying ≥21 days were predominantly female and had severe, diagnostically complex illnesses and high risk ratings. Most were still seriously unwell after 15 days. Patients improved significantly by the time of discharge (though were by no means recovered), indicating that the duration of hospitalisation was appropriate.
OBJECTIVES: : To perform a clinical and risk audit of private hospital inpatients staying in hospital at least 21 days. METHODS: : Of 492 admissions for ≥21 days in 2016, 40 were randomly selected for audit. Characteristics, illness severity and course using the Clinical Global Impression severity (CGI-S) subscale and improvement (CGI-I) subscale, and clinical risk profiles were ascertained at admission, day 15 and discharge by two psychiatrists. RESULTS: : The cases were 65% female, age 50.0±16.2 years (range 24-86), 43% in relationships, and 28% on disability support. The length of stay was 29±7 days. On admission 88% were severely or markedly ill on the CGI-S subscale. Thirty-nine of 40 cases had ≥3 psychiatric diagnoses: 93% depression, 48% bipolar, 15% schizophrenia. High risk was present in suicide risk (48%), illness-induced dysfunction risk (78%) and physical risk (28%). By day 15, 63% were not improved or marginally worse. Suicide ratings were unimproved. By the time of discharge, illness severity and risk ratings were significantly reduced. CONCLUSION: : Private hospital inpatients staying ≥21 days were predominantly female and had severe, diagnostically complex illnesses and high risk ratings. Most were still seriously unwell after 15 days. Patients improved significantly by the time of discharge (though were by no means recovered), indicating that the duration of hospitalisation was appropriate.
Entities:
Keywords:
Private hospital; audit; inpatient; mental health services; psychiatric treatment