Self-admission to inpatient treatment is a novel approach that aims to increase agency and autonomy for patients with severe psychiatric illness and a history of high utilization of inpatient care. By focusing on brief, preventive hospital admissions in times of increased risk of relapse, self-admission seeks to reduce the need for prolonged episodes of inpatient treatment. Participants are generally satisfied with the model, which is not surprising given that self-admission programs allocate a scarce resource-hospital beds-to a select group. However, the patients targeted by these programs are not necessarily those in most need of hospital admission, which may compromise the commonly accepted 'principle of need' in allocation of public healthcare resources. In light of the current lack of consistent evidence of the usefulness and cost-effectiveness of the model, several aspects need to be further studied in order to guide any large-scale implementation of self-admission in psychiatry.
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http://dx.doi.org/10.1111/bioe.12501 | DOI Listing |
Psychiatr Serv
December 2024
Dalla Lana School of Public Health (Dharma, Bondy), Department of Anthropology (Sikstrom, Muirhead), and Department of Psychiatry (Zaheer, Maslej), University of Toronto, Toronto; Krembil Centre for Neuroinformatics (Dharma, Sikstrom, Muirhead, Maslej) and General Adult Psychiatry and Health Systems Division (Zaheer), Centre for Addiction and Mental Health, Toronto.
BMC Health Serv Res
May 2021
Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, 171 77, Stockholm, Sweden.
Background: Self-admission to psychiatric inpatient treatment is an innovative approach to healthcare rationing, based on reallocation of existing resources rather than on increased funding. In self-admission, patients with a history of high healthcare utilization are invited to decide for themselves when brief admission is warranted. Previous findings on patients with severe eating disorders indicate that self-admission reduces participants' need for inpatient treatment, but that it does not alone lead to symptom remission.
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