Japanese Specialists Attitudes Toward Scheduled Care in Emergency Psychiatric Units: Development of a Care Pathway

Toshihiro Horiguchi

doi:10.21767/2471-9854.100010

Abstract

Background: Over 90 percent of psychiatric inpatients in Japan are discharged within a three-month period. Further efforts to reduce the duration of inpatient care are needed. Medical pathways that assure scheduled care are uncommon in psychiatry, and we collected the opinions of specialists regarding a tentative standard pathway. Methods and Findings: Two target groups that included 114 certified hospitals with an emergency psychiatric unit and 80 psychiatry departments of universities were requested to fill two tables for scheduled care for an example case vignette. The staff at 25 hospitals and 14 universities replied to our questionnaire. Many of the responses overlapped between the two groups. Their answers were used to plan a medical schedule with the aim of discharging patients within a shorter period of time. Conclusion: Despite several study limitations, we proposed a provisional pathway based on the agreements between the two groups. Standard psychiatric care pathways should become available in Japan.

Highlights

An authorized annual report [1] found that 4,814 persons were admitted to private psychiatry hospitals in Japan on June 30, 2012
The Japanese Ministry of Health, Labour and Welfare (MHLW) [2] concluded in 2012 that the duration of admission for all inpatients should be less than a year, except for those diagnosed as having a severe and chronic state
To reduce the duration of inpatient care and to activate collaboration among hospital staff, scheduled inpatient psychiatric care was newly implemented in the national payment system for medical expenses in Japan in 2014

Summary

Introduction

An authorized annual report [1] found that 4,814 persons were admitted to private psychiatry hospitals in Japan on June 30, 2012. Ninety percent or more of inpatients are discharged within three months in Japan. Based on such data, the Japanese Ministry of Health, Labour and Welfare (MHLW) [2] concluded in 2012 that the duration of admission for all inpatients should be less than a year, except for those diagnosed as having a severe and chronic state. To reduce the duration of inpatient care and to activate collaboration among hospital staff, scheduled inpatient psychiatric care was newly implemented in the national payment system for medical expenses in Japan in 2014. The hospital can charge for additional medical expenses if the patient is discharged within 60 days. Medical pathways that assure scheduled care are uncommon in psychiatry, and we collected the opinions of specialists regarding a tentative standard pathway

Methods

Results

Discussion

Conclusion