A prospective longitudinal study of utilization of a psychiatric hospital in Hordaland County, Norway, from 1985 to 2003

Abstract

Background: In Norway, as in the rest of the Western world, during the last three decades there has been a reduction of psychiatric hospital beds and expansion of extramural mental services, more based on ideology than empirical research. Aims: To study the use of a psychiatric hospital before and after expansion of the outpatient psychiatric care in Hordaland County, Norway from 1985 to 2003. Methods: All patients admitted from a catchment area of 168,000 inhabitants were included in a prospective longitudinal study. Results: During the study period, there was a decrease in psychiatric hospital beds in the county. From 1991 to 2003, the annual number of outpatient consultations in District Psychiatric Centres more than doubled, but none of the four psychiatric hospitals in the county showed any decline in the number of admitted patients. Since 1995, there was a 100% increase in the annual number of stays, number of individual patients and number of first-stay patients admitted to the psychiatric hospital serving the inner-city area of Bergen, the main city in Hordaland, and the surrounding countryside. In this hospital, the annual number of patients with a drug/alcohol problem showed a fivefold increase. The same was the case for patients from the immigrant population. The annual number of first stays and hospital days for patients aged 20–29 years from the rural area increased more than twofold. Conclusion: There is still an increased need for specialized inpatient hospital mental healthcare, despite the growth of the extramural mental health services.

• Extra mural mental services
• Length of stay
• Occupancy ratio
• Psychiatric hospitalization
• Rehospitalization

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.