Annual psychiatric hospital admission rates in England vary markedly from region to region, according to a new study from the University of Bristol published in the British Journal of Psychiatry this week.
The research also shows that men are more likely than women to be admitted to hospital for psychiatric reasons, and that psychiatric admissions are more common for depression and anxiety than for psychosis.
The study, led by Dr Andrew Thompson, Clinical Lecturer in Psychiatry at the University, used the Department of Health’s national Hospital Episode Statistics data on admissions to NHS hospitals in England between April 1999 and March 2000. It looked at admission rates of patients aged between 16 and 64 by region, age, gender and diagnosis.
Although the number of in-patient psychiatric beds in England has fallen dramatically over the past 40 years, hospitalisation still accounts for about 75% of NHS spending on mental health. The assessment and reporting of national patterns of psychiatric hospital admissions is important for strategic service development and planning.
The researchers found that there were 102,980 admissions to psychiatric hospitals in England during the study period. The overall annual admission rate for England was 3.2 per 1000 population. Rates were highest in the North West region (3.8 per 1000) and lowest in the Eastern region (2.7 per 1000).
Overall, the admission rates were higher for males (3.3 per 1000) than females (3.0 per 1000). The gender ratio was narrowest in the older age groups.
Reasons for admission were as follows:
- Depression and anxiety 29.6%
- Schizophrenia and related psychoses 26%
- Substance misuse 19.1%
- Others 12.2%
The proportion of admissions for schizophrenia and related psychoses was higher than for depression and anxiety in London only. The proportion of admissions for substance misuse was highest in the North West region, and for organic disorders in the Northern and Yorkshire region.
Despite policy initiatives to provide alternatives to in-patient care, length of stay exceeded 90 days in 9.2% of admissions, and one year in 0.9% of admissions.
Average length of stay (in days) for various psychiatric specialties was as follows:
- child and adolescent 155
- forensic 79
- mental handicap 40
- psychotherapy 40
- mental illness 15
- old age 14
Although the London region had the second lowest admission rate, it had the highest proportion of long-stay patients. Length of stay was greatest for schizophrenia, almost twice that for depression and anxiety.
Dr Thompson said: “The findings of the study may point to variations in service delivery or availability. The impact on patient outcomes is uncertain.”
Paper: ‘Patterns of admission for adult psychiatric illness in England: analysis of Hospital Episode Statistics data’, British Journal of Psychiatry