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Admission to In-patient Psychiatric Care in the Veneto Region (Italy), Specialisation vs. Personal Continuity of Care Approach. Preliminary Findings from the COFI Study-Italian Sites

Published online by Cambridge University Press:  23 March 2020

E. Miglietta
Affiliation:
University of Verona, Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, Verona, Italy
A. Lasalvia
Affiliation:
University of Verona, Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, Verona, Italy
P. Sara
Affiliation:
University of Verona, Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, Verona, Italy
G. Zanatta
Affiliation:
University of Verona, Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, Verona, Italy
S. Zoppei
Affiliation:
University of Verona, Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, Verona, Italy
G. Dimitri
Affiliation:
University of Verona, Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, Verona, Italy
C. Comacchio
Affiliation:
University of Verona, Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, Verona, Italy
D. Cristofalo
Affiliation:
University of Verona, Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, Verona, Italy
C. Bonetto
Affiliation:
University of Verona, Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, Verona, Italy
D. Giacco
Affiliation:
Queen Mary University of London, Unit for Social and Community Psychiatry, London, United Kingdom
S. Priebe
Affiliation:
Queen Mary University of London, Unit for Social and Community Psychiatry, London, United Kingdom
M. Ruggeri
Affiliation:
University of Verona, Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, Verona, Italy

Abstract

Introduction

In Italy, considerable variations exist in the organisation of out- and in-patient mental health care. One main issue is whether to prioritise specialisation (distinct clinicians for inpatient and outpatient care) or personal continuity of care (same primary clinician for a given patient within the two settings).

Aims

To study the use of psychiatric in-patient units in the Veneto region (Italy) and to evaluate differences between personal continuity of care and specialization systems.

Methods

Study conducted in the context of the COFI, multisite naturalistic EU-funded research aiming to compare the two care approaches in 5 European countries. In Italy, baseline data collection was carried out in 14 in-patient units. Data on hospitalisation, diagnosis, severity of the illness (Clinical Global Impression Scale- CGI) and patients’ appraisal of inpatient care (Client Assessment of Treatment Scale- CAT) were collected.

Results

Overall, 1118 patients were assessed. Most frequent diagnostic categories were mood (41.6%) and psychotic (38.3%) disorders, while anxiety disorders were less represented (11.9%). The majority of patients were at least at their second admission (69.4%) and had been voluntary admitted (91.5%). Length of stay and CGI scores were significantly higher for patients with mood and psychotic disorders. No difference in CGI score between the two systems was found. Patients in the continuity of care systems reported higher level of satisfaction with initial treatment and longer hospital stay (P < .001).

Conclusions

These preliminary findings suggest higher service satisfaction for personal continuity system, possibly reflecting a more individualised and comprehensive focus on the patient's needs, rather than on symptoms reduction only.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Type
e-Poster viewing: Mental health policies
Copyright
Copyright © European Psychiatric Association 2017
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