Abstracting Psychiatric Patient Data in General Hospitals

Abstract

ing Psychiatric Patient Data In General Hospitals PETER L. HURLEY, B.S., and PHILIP H. PERSON, Jr., Ph.D. FOR SEVERAL YEARS the Office of Biometry, National Institute of Mental Health, Public Health Service, has been collecting data on patients in public and private mental hospitals, public and private institutions for the mentally retarded, and psychiatric patients in general hospitals. During this time the number of known psychiatric admissions to general hospitals has been increasing. In 1963 total admissions were 212,000, based on a 63 percent response to the annual National Institute of Mental Health general hospital survey. An estimate that takes account of the under-reporting suggests that the total number of admissions is closer to 350,000. This is more than the total number of admissions to State and county mental hospitals in 1963. In addition, about 75 percent of psychiatric discharges from general hospitals are made directly to the community, suggesting that general hospitals may be serving extensively as transitional facilities or as alternatives to public mental hospitals. Psychiatric facilities in general hospitals affect the number and characteristics of patients admitted to mental hospitals and other psychiatric facilities in areas they serve. Data collection methods for the general hospitals should be geared to determining the effect on these facilities. In the past the National Institute of Mental Health has collected from general hospitals only minimal data on psychiatric patients, including tabulations on the number of admissions, discharges, and deaths in the hospital during the year and the distribution of psychiatric discharges by diagnosis and sex. The data collection forms have been geared to yearend tabulations of these categories and variables. Optionally, this requires a separate subsystem to record psychiatric admissions and discharges and characteristics of the patients, so that the needed data will be available for use at the year's end. The forms have been quite difficult to complete in some general hospitals. When a separate system is not used, it becomes necessary to search the hospital records merely to identify those pertaining to psychiatric patients, to say nothing about tabulating the requested data. The task is time consuming and difficult in hospitals with small proportions of discharged patients having psychiatric diagnoses. Not only has the data collected in the past been minimal, but the percent of hospitals reporting has been low (see table). A method is needed which will make the abstracting and compiling easier and provide a greater amount of useful information. An obvious answer is to record certain basic data on each psychiatric patient at the time of the patient's discharge from the hospital. A form developed to meet these requirements is shown in the figure. The form contains the Mr. Hurley and Dr. Person are with the Office of Biometry, National Institiute of Mental Health, Public Health Service. Vol. 81, No. 6, June 1966 563 This content downloaded from 157.55.39.45 on Fri, 02 Sep 2016 05:52:52 UTC All use subject to http://about.jstor.org/terms patient's name, case number, age, psyclhiatric diagnosis, length of stay, and recommendation at the time of discharge. The part containing the patient's name can be removed prior to submission to the National Institute of Mental Health for processing and tabulation, since the names are of no use in data processing and analysis at the national level. Any followup, necessary because of discrepancies in the data, can be done with the hospital patient number. However, the name is of value for identification purposes within the hospital. The form is prepared in pads so carbon copies can be made easily. The next step was to initiate a pilot study to evaluate the reporting form and method of collecting data. Because of the interest in this project expressed in Wisconsin, it was decided to pretest the form and method in several general hospitals in that State. The project had the support of the Wisconsin State Department of Public Welfare, the division of mental hygiene, and the division of hospitals and related services in the State board of health.