TY - JOUR
KW - Community Mental Health Services/statistics & numerical data/trends
KW - Comorbidity
KW - Great Britain
KW - Humans
KW - Medical Audit/statistics & numerical data
KW - Mental Disorders/epidemiology
AU - E. N. Bongards
AU - R. Zaman
AU - M. Agius
A1 - 
AB - BACKGROUND: Patients with 'simple' mental health problems should be able to be managed exclusively in primary care. It is therefore anticipated that only the more complex cases would be referred to secondary care. In order to test this hypothesis, the number of patients registered with a community mental health team (CMHT) in Bedford, United Kingdom, who had received multiple psychiatric diagnoses in 2010, 2011 and 2013, was determined and analysed. METHOD: Using a secure and anonymised Microsoft Excel(R) database that contains all patient data, the proportions of patients with more than one diagnosis were audited and thus determined for the months of August 2010, June 2011 and February 2013. The total number of patients registered was also determined for comprehensiveness. We had established the basic audit standard that every patient should have only one mental health diagnosis if this was possible. RESULTS: Many patients were indeed found to have received multiple diagnoses. Furthermore, an increase in the proportion of patients with multiple diagnoses was observed; from 23.2% in 2010 to 25.2% in 2011 to 34.3% in 2013. DISCUSSION: Several psychiatric conditions have been shown to be associated with particular psychiatric co-morbidities, which may be one reason why many of the Bedford CMHT's patients receive multiple diagnoses. Furthermore, the trend observed may reflect improving mental healthcare in primary care and therefore fewer referrals of patients with 'simple' mental health conditions to secondary care, thus causing the CMHT's caseload to become increasingly complex. It may also reflect improving communication between primary and secondary care, which may also lead to fewer referrals. Finally, the trend may merely reflect better use of the available database. CONCLUSION: We have found that numerous patients received multiple diagnoses. We have also observed an increase in the proportion of such patients over three years, which may reflect improved management of mental health problems in primary care. Our results may therefore provide an incentive to establish formal shared care of psychiatric patients between primary and secondary care to improve patient management even further. Furthermore, our results reflect the complexity of the cases referred to secondary care, which are far more difficult to treat than those exclusively managed in primary care.
BT - Psychiatria Danubina
C5 - General Literature
CY - Croatia
JF - Psychiatria Danubina
N2 - BACKGROUND: Patients with 'simple' mental health problems should be able to be managed exclusively in primary care. It is therefore anticipated that only the more complex cases would be referred to secondary care. In order to test this hypothesis, the number of patients registered with a community mental health team (CMHT) in Bedford, United Kingdom, who had received multiple psychiatric diagnoses in 2010, 2011 and 2013, was determined and analysed. METHOD: Using a secure and anonymised Microsoft Excel(R) database that contains all patient data, the proportions of patients with more than one diagnosis were audited and thus determined for the months of August 2010, June 2011 and February 2013. The total number of patients registered was also determined for comprehensiveness. We had established the basic audit standard that every patient should have only one mental health diagnosis if this was possible. RESULTS: Many patients were indeed found to have received multiple diagnoses. Furthermore, an increase in the proportion of patients with multiple diagnoses was observed; from 23.2% in 2010 to 25.2% in 2011 to 34.3% in 2013. DISCUSSION: Several psychiatric conditions have been shown to be associated with particular psychiatric co-morbidities, which may be one reason why many of the Bedford CMHT's patients receive multiple diagnoses. Furthermore, the trend observed may reflect improving mental healthcare in primary care and therefore fewer referrals of patients with 'simple' mental health conditions to secondary care, thus causing the CMHT's caseload to become increasingly complex. It may also reflect improving communication between primary and secondary care, which may also lead to fewer referrals. Finally, the trend may merely reflect better use of the available database. CONCLUSION: We have found that numerous patients received multiple diagnoses. We have also observed an increase in the proportion of such patients over three years, which may reflect improved management of mental health problems in primary care. Our results may therefore provide an incentive to establish formal shared care of psychiatric patients between primary and secondary care to improve patient management even further. Furthermore, our results reflect the complexity of the cases referred to secondary care, which are far more difficult to treat than those exclusively managed in primary care.
PP - Croatia
PY - 2013
SN - 0353-5053; 0353-5053
EP - 9
EP - S247+
T1 - Audit to identify the number of patients with multiple diagnoses in a community mental health team in Bedford, England
T2 - Psychiatria Danubina
TI - Audit to identify the number of patients with multiple diagnoses in a community mental health team in Bedford, England
U1 - General Literature
U2 - 23995186
VL - 25 Suppl 2
VO - 0353-5053; 0353-5053
Y1 - 2013
ER -