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Author (up) Abas, M.; Vanderpyl, J.; Prou, T.L.; Kydd, R.; Emery, B.; Foliaki, S.A. url 
  Title Psychiatric hospitalization: reasons for admission and alternatives to admission in South Auckland, New Zealand Type Journal Article
  Year 2003 Publication Australian & New Zealand Journal of Psychiatry Abbreviated Journal  
  Volume 37 Issue 5 Pages 620-625  
  Keywords admission; acute inpatient units; Psychiatry; Psychiatric units; psychosis; involuntary admission; Social deprivation; medication; perscriptions; medication conconrdance; discharge; nurse-staffed accomodation; community treatment  
  Abstract Objective: To describe reasons for admission and alternatives to admission in a government funded acute inpatient unit.Method: Reasons for admission and alternatives to admission were rated for a consecutive sample of 255 admissions to an acute psychiatric unit in Auckland, using interviews with staff and case note review.Result: Most patients had a functional psychosis and were admitted involuntarily. Forty percent came from areas of marked social deprivation. The major reasons for admission were for reinstatement of medication (mainly linked to non-concordance with prescribed medication), intensive observation, risk to self and risk to others. Only 12% of admissions could have been diverted, of whom most would have required daily home treatment. For those still admitted at 5 weeks, 26% could have been discharged, mainly to 24 h nurse-staffed accommodation. If the alternatives had all been available, simulated bed-day savings were 11 bed years per year. Simulated bed day savings were greater through implementing early discharge than by diverting new admissions.Conclusion: Greater availability of assertive community treatment and of interventions to improve medication concordance may have prevented a small number of admissions. For patients admitted longer than 5 weeks, it appeared that greater availability of 24 h nurse-staffed accommodation would have allowed considerable bed-day savings.  
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  Call Number TRM @ admin @ Abas,M.etal-Psychiatrichospitalization:reasonsforadmissionandalternativestoadmissioninSouthAuckland,NewZealand Serial 21  
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