Vast Majority of Psychiatric Treatment in Community Hospitals Occurs in Specialty Units

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Over 90 percent of psychiatric patients who received treatment in community hospitals were cared for in hospital-based psychiatric specialty units, according to a study sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA) and the U.S. Agency for Healthcare Research and Quality (AHRQ) and published today in Psychiatric Services.

The study investigated the extent to which community hospitals treated patients with psychiatric disorders in specialty psychiatric units versus general medical beds (sometimes known as “scatter” beds.) The study focused on community hospitals and did not examine care in free standing psychiatric hospitals or other settings.

Overall, 93.2 percent of patients admitted to hospitals with psychiatric disorders were cared for in psychiatric units and 6.8 percent were assigned to scatter beds.

The study found notable differences in the type of care provided by psychiatric units and scatter bed settings as well as differences in the types of patients assigned to the two settings. Among the major findings:

Patients treated in scatter bed settings were more likely to be older and on Medicare than patients treated in psychiatric units.

Patients treated in scatter beds settings were more likely than patients treated in psychiatric units to be admitted from the emergency room, have shorter lengths of stay, and be transferred to another facility.

Patients treated in scatter beds settings were less likely than patients treated in psychiatric units to have suffered from schizophrenia, episodic mood disorders, or depressive disorders.

“This study shows that the vast majority of psychiatric admissions at community hospitals are getting treatment in specialty psychiatric units.” said SAMHSA Administrator Pamela S. Hyde J.D. “Nevertheless, we must continue to be vigilant and ensure that access to needed specialized treatment is provided as health reform shapes new care systems.”

“AHRQ was pleased to collaborate with SAMHSA on this very important study that highlights the psychiatric care being given in community hospitals,” said Carolyn M. Clancy, AHRQ’s director. “It’s findings will help inform clinician and policymaker efforts to improve access to, and ensure the quality of, psychiatric services for all Americans.”

The study also revealed wide variation in the number of community hospital psychiatric discharges per capita across the states, from 9.6 per 10,000 residents to 62.3 per 10,000 suggesting the potential need for assessments of the appropriate supply of psychiatric unit beds across geographic locations.

The study was based on an analysis of the Healthcare Cost and Utilization Project State Inpatient Databases. The study was done in conjunction with SAMHSA’s strategic initiative to prevent and reduce mental illness and substance abuse.

SAMHSA is a public health agency within the Department of Health and Human Services. Its mission is to reduce the impact of substance abuse and mental illness on America’s communities.

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Source:  Substance Abuse and Mental Health Administration (SAMHSA)

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