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THE NEED FOR UNIFORM DISCHARGE STATISTICS IN PUBLIC PSYCHIATRIC HOSPITALS
WALTER E. BARTON; HARVEY J. TOMPKINS; AARON B. NADEL
Am J Psychiatry 1949;106:429-440.
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Superintendent of the Boston State Hospital.

Chief, Psychiatry and Neurology Division, Veterans Administration.

Special Assistant to Chief, Psychiatry and Neurology Division, Veterans Administration.

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Abstract

1. In the year July 1, 1946 to June 30, 1947 there were admitted to the Boston State Hospital 1,220 patients, 859 of whom were first admissions. At the end of the study period, 60% were out of the hospital, 20% were dead, and 20% were still in residence.2. Analysis of the 727 patients who were out of the hospital reveals that 50% were released in less than 30 days with an average hospital residence of 9 days; 20% left in 3 months to a year with an average stay of 4 months; and 30% were released after a year of hospital residence with an average of 1.42 years. The average stay in the hospital of all those leaving was 6 months.3. Of the patients admitted in the year studied, 250 died after an average hospital residence of 160 days. The average age of those who died was 73 years.4. A study of what happened to the admissions to 2 veterans hospitals during 3 months after 180 days had elapsed showed that over 70% were out of the hospitals at that time. Examinations of the sample in each hospital revealed the prevailing diagnostic categories were psychoses, 34-40%; alcoholic intoxication and drug addiction, 31-35%; psychoneurotic disorders, 14-13%. At the end of the 180-day period, of those remaining in the hospital 81% and 87% were with psychoses.5. Statistical reports would gain in value if all psychiatric hospitals employed a standard diagnostic group such as the following:Transient personality reactions. Psychoneurotic disorders. Character and behavior disorders. Alcoholic intoxication and drug intoxication. Disorders of intelligence. Psychoses. Neurological disorders. No disease following observation.6. A simple method of reporting discharge statistics has been presented. It is recommended that all psychiatric hospitals adopt it. Discharge figures so reported relating directly to admissions would serve as a crude measure of the efficiency of treatment that would be comparable if compiled by all hospitals.7. The basis for the proposed simplified method of reporting discharge statistics is the answer to the questions:(1) Where is the patient admitted one year ago? (a) First admissions. (b) Re-admissions.(2) How long was the stay in the hospital (of those who left within the year or died)? ( a) Average length of stay. (b) Median length of stay.(3) What patients were discharged after more than 12 months from time of admission? (a) What was the length of stay: Average? Median?

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