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Inpatient or day clinic treatment? Results of a multi-site-study

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Author(s): Zeeck, Almut | von Wietersheim, Jörn | Hartmann, Armin | Einsele, Sanna | Weiss, Heinz | Sammet, Isa | Gaus, Ekkehard | Semm, Eckart | Harms, Dirk | Eisenberg, Andrea | Rahm, Roland | Küchenhoff, Joachim

Journal: GMS Psycho-Social-Medicine
ISSN 1860-5214

Volume: 6;
Start page: Doc03;
Date: 2009;
Original page

Keywords: differential indication | inpatients | day clinic | psychosomatics | prediction

ABSTRACT
Objective: This naturalistic study aimed to identify criteria which are of relevance for making a decision as to whether inpatient or day hospital treatment is indicated.Methods: In 567 patients who were consecutively admitted to 10 departments of psychosomatic medicine (day hospital or inpatient setting) in Germany, symptom severity at admission and discharge was measured (Symptom-Check-List-90-R, Global Assessment of Functioning). Before admission, clinicians rated aspects that might be important for differential indication (Rating Scale of Indication Criteria). A regression analysis was conducted to reveal relationships between outcome in each setting and possible predictors (criteria of relevance).Results: At admission inpatients and day clinic patients already showed some differences referring to aspects clinicians used to select patients for each setting. Good outcome in day hospital patients was associated with a high motivation and higher burdens at home, whereas reduced drive and loss of interest was correlated with a less favourable course. Inpatients did less well if their symptoms were triggered by situations at home and if they showed a high potential for regression.Conclusion: Results give first hints for criteria which are relevant for making a decision between inpatient and day hospital treatment in psychosomatic medicine.
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