Inpatient service use before and after a mental health inpatient rehabilitation admission

Background

Inpatient mental health rehabilitation services provide specialist treatment to people with complex psychosis. On average, rehabilitation admissions last around one year and usually follow several years of recurrent and often lengthy psychiatric hospital admissions.

Aim

To compare inpatient service use before and after an inpatient rehabilitation admission using electronic patient healthcare records in one NHS Trust in London.

Method

Individuals with an inpatient rehabilitation admission which started between 1st January 2010 and 30th April 2019, which lasted for at least 84 days, and where the individual had at least 365 days of records before and after their rehabilitation admission, were included in the study. Regression modelling was used to compare inpatient days before and after the rehabilitation admission, whilst controlling for the variation in the length of pre- and post-rehabilitation admission periods and potential confounding variables, using incident rate ratios.

Results

A total of 172 individuals met the study eligibility criteria. They had a mean of 4.4 years (SD 2.2) of records available before the rehabilitation admission with a mean of 519 inpatient days (SD 400) during this period, and a mean of 5.2 years (SD 2.4) of records available after the admission with a mean of 411 inpatient days (SD 595) during this period. The adjusted regression model produced an incident rate ratio of 0.520 (95% CI 0.367 to 0.737).

Conclusion

The rate of inpatient service use was halved in the period after an inpatient rehabilitation admission compared to the period before.