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Use of psychiatric inpatient services by heavy users: Findings from a national survey in Italy

Published online by Cambridge University Press:  16 April 2020

M. Morlino ,
A. Calento ,
V. Schiavone ,
G. Santone ,
A. Picardi ,
G. de Girolamo  and
for the PROGRES-Acute group
M. Morlino
Affiliation:
Department of Neuroscience and Behavioral Science, Section of Psychiatry, University Medical School Federico II, via Pansini 5, 80131Naples, Italy
A. Calento
Affiliation:
Department of Neuroscience and Behavioral Science, Section of Psychiatry, University Medical School Federico II, via Pansini 5, 80131Naples, Italy
V. Schiavone
Affiliation:
Department of Neuroscience and Behavioral Science, Section of Psychiatry, University Medical School Federico II, via Pansini 5, 80131Naples, Italy
G. Santone
Affiliation:
Psychiatric Unit, United Hospitals of Ancona, Polytechnic University of Marche, via Conca, 60020Ancona, Italy
A. Picardi
Affiliation:
Mental Health Unit, Center of Epidemiology, Health Surveillance and Promotion, Italian National Institute of Health, 299, Viale Regina Elena, 00161Rome, Italy
G. de Girolamo*
Affiliation:
IRCCS Centro San Giovanni di Dio–Fatebenefratelli, via Pilastroni, 4, 25125Brescia, Italy
*
* Corresponding author. Tel.: +39 0303 501 590; fax: +39 0303 533 511. E-mail address: [email protected] (G. de Girolamo).
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Abstract

Purpose

To analyze factors associated with a patient's probability of being a Heavy User (HU) of inpatient psychiatric services and to compare the HU inpatient population with Non-Heavy Users (NHUs).

Patients and methods

The survey was conducted among inpatients enrolled in the PROGRES-Acute-project, an Italian nationwide survey of public and private inpatient facilities. Patients with three or more admissions over the last 12 months were considered HUs, and patients who had undergone one or two admissions during the same period made up the NHU group.

Results

Four hundred and thirty-five (40.5%) were HUs, and 640 (59.5%) NHUs. HUs were younger, more frequently unmarried, unemployed, receiving a disability-pension, and either homeless or living in a residential facility. HUs were more likely to have experienced conflicts with their partners or family members during the week prior to admission. A logistic regression analysis revealed that age, age at first admission, number of life-time admissions, and having been the victim of violence were the most important predictive factors for the HU phenomenon.

Conclusion

Our study suggests that specific attention should be given to patients’ family context, due to its crucial role in daily informal care and in the triggering of events leading to rehospitalization.

Keywords

EpidemiologyHeavy usersPatterns of careResidential facilitiesRe-hospitalization
Type
Original article
Information
European Psychiatry , Volume 26 , Issue 4 , May 2011 , pp. 252 - 259
Copyright
Copyright © Elsevier Masson SAS 2011

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Footnotes

1

The PROGRES-Acute group includes: National and Regional Coordinators, and scientific consultants: F. Amaddeo, A. Barbato, G. Borgherini, G. Borsetti, R. Bracco, R. Canosa, M. Casacchia, I. Casula, P. Ciliberti, A. Colotto, A. D’Aloise, G. de Girolamo, G. Dell’Acqua, M. De Palma, W. Di Munzio, A. Gaddini, G. Grassi, N. Longhin, M. Miceli, R. Miglio, P. Morosini, M. Nicotera, M. Percudani, B. Norcio, A. Picardi, R. Potzolu, E. Rossi, P. Rucci, G. Santone, S. Schiaffino, F. Scotti, R. Tomasi, G. Turrini, E. Zanalda. Researchers: G. Agostani, F. Basile, F. Basilico, N. Battino, L. Bavero, G. Bazzacco, L. Biscaglia, R. Borio, S. Buttacavoli, B. Caporali, F. Cappelletti, L. Caserta, L. Cifarelli, P. Congia, M. Dazzi, L. Elia, E. Fantini, A. Galli, R. Gangi, P. Ghirardo, L. Giordano, S. Goldoni, A. Guidoni, S. Marchegiani, G. Morelli, M. Nassisi, E. Paltrinieri, K. Pesaresi, A. Pettolino, L. Pinciaroli, G. Pitzalis¸ M. Severini, C. Sighinolfi, G. Spinetti, A. Trequattrini, U. Unterfrauner, K. Wolf, L. Zecca.

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