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Few Psych Patients in Community Hospitals Are Placed in General Wards

The majority of patients who are treated in non-psychiatric hospitals for psychiatric issues are cared for in hospital-based psychiatric units, not general medicine beds, or "scatter beds."

The majority of psychiatric patients treated in community hospitals are cared for in hospital-based psychiatric units, according to a study by the Substance Abuse and Mental Health Services Administration (SAMHSA) and the US Agency for Healthcare Research and Quality (AHRQ).

Overall, 93.2% of patients admitted to the hospital for a psychiatric disorder were cared for in psychiatric-specific units, whereas only 6.8% were assigned to “scatter beds” or general medical beds. The researchers, who included SAMHSA administrator Pamela S. Hyde, JD, and Carolyn M. Clancy, MD, AHRQ's director, describe notable differences in the type of care that was provided to patients in psychiatric units and those patients in scatter beds. Major findings include:

- 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 bed 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 bed settings were less likely than patients treated in psychiatric units to have suffered from schizophrenia, episodic mood disorders, or depressive disorders.”

The researchers obtained hospital data on patients who were discharged with a principal psychiatric diagnosis. Patients who were discharged from community hospital psychiatric units (n=370,984) and patients discharged from scatter beds (n=26,969) were analyzed.

Although Clancy said that the findings “will help inform clinician and policymaker efforts to improve access to, and ensure the quality of, psychiatric services for all Americans,” the researchers conclude in Psychiatric Services that “more research is needed to determine the optimal supply of psychiatric unit beds across regions and whether and how scatter beds should be used to address the lack of psychiatric beds.”