Organization of psychiatric services, availability of programs of care and different approaches to treatment influence actual clinical outcome. Psychiatric hospitals usually consist of different wards nad units, to and from which patients are directed inside an episode of inpatient treatment. The aim of the study was to get insight into actual movements of patients betweeen different wards in a large University Psychiatric Hospital and relate these data to clinical outcome.

Hospital database was used as a source of data on patient movements and episodes of hospitalization. 2053 patient records were reviewed for clinical outcome data. Patients with three or more movements were diagnostically rechecked prospectivelly for the purpose of this study using ICD-10 research criteria. Appropriatness of treatment choice was assessed using patient treatment records.

1275 hospitalization episodes were reviewed. 35% of patients were moved between the wards three or more times. Within this group diagnostic discordance was noticed, that influenced changes in the treatment choice after each ward change.

Discordance in diagnostic and treatment choices within same hospital but different wards influenced significantly the course of hospitalization as well as outcome of clinical presentations.