Acute inpatient admissions in a community oriented old age psychiatry service

Objective: This study reviewed all inpatient admissions in a community oriented old age psychiatry service with the aim of assessing the appropriateness of admission criteria, obtaining a profile of those admitted, and providing information about service utilisation.Method: A retrospective chart review of all first inpatient admissions from 1989-1993 was carried out. Information concerning sociodemographic and clinical variables, and outcome measures in terms of discharge destination, was obtained.Results: There were 205 first admissions in the study period. There were 37 patients (18%) admitted on an involuntary basis. One per cent of admissions were not assessed at home prior to admission. Six patients had no formal psychiatric disorder, of the remainder 53% had an organic, and 47% a functional psychiatric disorder. Of those admitted 68% were discharged to their original destination. Patients with dementia were more likely to be discharged to nursing homes. Other discharge destinations were also used.Conclusions: The policy of initial domiciliary assessment of all referrals prior to admission is feasible in the majority of cases. Defined admission criteria clarify reasons for admission, and ensures appropriate use of beds. The range of discharge destinations highlights the need for maintaining close ongoing links with other service providers.