Abstract
BackgroundOne of the most typical and chronic problem in Korean mental health system is the prolonged length of hospital stay. In contrast to there are many components which leads to long length of stay of psychiatric patients in Korean situation such as low and fixed medical fee for psychiatric inpatient treatment, shortage of community resources, lack of care-givers’ awareness and so on, there are just few mechanisms to handle this issue such as Mental Health Review Board (MHRB) which is based on Mental Health Act since 1995. However, the discharge order rate was very low and there community care system after discharge order is still very weak.Case descriptionThe Korean government has revised the Mental Health Act in 2008 and changed the operating principals of the MHRB from a regional level to a local level to strengthen the function of MHRB. However, the discharge order rate versus the whole evaluation requests still remains at a very low level or less than 5%. And it is still very difficult to execute a discharge order against a patient whose symptoms and conditions become psychiatrically stabilized enough for discharge, due to a shortage of community care facilities and a lack of social support system. These results are exactly same with former studies.DiscussionAny policies to promote psychiatric discharge including MHRB are needed to take the comprehensive factors into consideration, such as payment program, community infrastructure, increasing care-givers’ acceptance and so on.ConclusionDespite of the political trial of Korean government to reduce length of stay of chronic psychiatric patients, it was not successful. Still it had failed to propose a detailed policy measure in terms of the above-mentioned prerequisites. Therefore, new system and program developments including reform of payment system which reflect prior studies’ recommendations are essential.
Highlights
One of the most typical and chronic problem in Korean mental health system is the prolonged length of hospital stay
Case description: The Korean government has revised the Mental Health Act in 2008 and changed the operating principals of the Mental Health Review Board (MHRB) from a regional level to a local level to strengthen the function of MHRB
According to a study conducted in 1999 regarding the appropriateness of hospitalization [3], the rate of inappropriate hospital admissions was recorded at approximately 50%, which indicated that patients are hospitalized for medical reasons, and for social reasons, including the absence of a caregiver or the absence of a residence
Summary
One of the most typical and chronic problem in Korean mental health system is the prolonged length of hospital stay. It is still very difficult to execute a discharge order against a patient whose symptoms and conditions become psychiatrically stabilized enough for discharge, due to a shortage of community care facilities and a lack of social support system. These results are exactly same with former studies. The most typical problem of the mental health system in Korea is the increasing trend in the number of psychiatric beds along with the prolonged length of hospital stay. Another study carried out by Seoul City in 2009 [5] displayed that the rate of hospital admissions for social reasons remained at about 30%, which was slightly improved compared to 10 years ago
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