Discharge management for patients in Flemish psychiatric hospitals.

Rationale And Aims: At the end of the 1990 s, a case management service called 'discharge management' was implemented in Belgian psychiatric hospitals. This study aimed to describe the profile of patients receiving discharge management in Flemish psychiatric hospitals as well as to analyse the discharge management indicators of these hospitals on micro and meso level.

Methods: Ten Flemish psychiatric hospitals participated. A descriptive analysis of the profile of patients receiving discharge management (gender, age, length of stay, family situation, assistance at home, living environment and Global Assessment of Functioning) and of the indicators of discharge management (screening, interdisciplinary patient file, interdisciplinary meeting, timely announcement of discharge date, transfer of discharge documents, readmission and institutionalization) were carried out.

Results: Of the 1306 patients included in the database, one-fourth received discharge management. In general, patients (54% were male) were about 45 years old, stayed for 55 days in hospital, were single and had no aid at home. Most of them came from and returned to their own home. On the micro level of discharge management, nearly all patients were screened and half of them were positively screened. Half of these patients received discharge management. Of the discharged patients who received discharge management (meso level), 13.5% were institutionalized after discharge, 37.6% had been previously admitted and 27.2% received discharge management during that previous admission. Differences between diagnostic groups occurred.

Conclusion: Hospitals have made efforts to support and prepare patients for discharge, although a number of improvements are suggested for different indicators.