A descriptive study of the characteristics and discharge outcomes of acute psychiatric admissions at district and regional hospitals in the Cape Town Metropole region of South Africa

Scheepers, Robin

A descriptive study of the characteristics and discharge outcomes of acute psychiatric admissions at district and regional hospitals in the Cape Town Metropole region of South Africa

Master Thesis

2019

Abstract

Background Mental disorders are the third most important contributor to the burden of disease in South Africa. In a resource-limited setting such as South Africa, rational mental health service planning requires assessment of the characteristics and outcomes of mental health services. Aim This study aimed to detail the characteristics and discharge outcomes of acute psychiatric admissions at district and regional hospitals in the Cape Town Metropolitan region of South Africa which serves an estimated population of 1.5 million people. Methods and Setting A retrospective descriptive cohort study was conducted, examining all acute psychiatric admissions from 1 April 2012 to 31 March 2013. Admission data were gathered from four hospitals in the catchment area of Valkenberg Hospital, a psychiatric hospital serving the Cape Town metro region. Results Psychotic and Mood disorders were the most common diagnostic categories. Male and older patients (>60 years), and those with substance-related disorders had significantly longer admissions. Transfer to psychiatric hospitals and internal transfers significantly increased the duration of admission. Admission to Groote Schuur Hospital was associated with a significantly longer length of stay. Patients were more likely to be readmitted within 30 days following discharge from district or regional hospitals than Valkenberg Hospital. Conclusion Several areas of focus to be addressed were identified, namely substance use interventions, access to specialized care at primary and secondary level and the need for additional specialist inpatient psychiatric resources. Further analysis of retention in care following discharge from district and regional hospitals is recommended to unpack factors that are associated with readmission.

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