Free Nursing Dissertations - (rouse Et Al 2001) clearly This Is Of Great Relevance To Our Considerations
(Rouse et al 2001)
Clearly this is of great relevance to our considerations as when staff are faced with requests for readmission they have a moral obligation to try to accommodate it even if bed occupancy rates are higher than optimum. (Kuhse & Singer 2001).
We shall discuss the whole issue of bed availability later on in this review. In order to put it into context however, we should note that there has been a very significant shift in the bed provision in the mental health sector in the last 50 years. It has swung away from the primarily institutional setting, and into the community. The scale of this shift is to be realised when one considers that the number of beds designated for the psychiatric patient was 154,000 in 1954 and this number has now fallen to 33,000 in the whole of the UK. (D of H 2004).
It is not suggested that this is simply a matter of cutbacks. There is clearly the rationalisation and advance of treatment which has undoubtedly allowed many more patients to be safely cared for in the community, but there is still the continued debate over whether the 33,000 beds are actually enough to satisfy the demands of the community for both admission and readmission of the acutely mentally ill. (Latack J C 1999)
We will do no more than simply present these facts directly, as they are fundamental to the understanding of the background to the issues to be considered. Being Government publications, they are not attributed and simply reflections of policy.
There is a large body of opinion which has expressed concern that the trend for deinstitutionalisation that has been apparent in the UK since the ‘80s. This, together with the concomitant rise in the aspects of managed healthcare, have led to a loss of focus on the needs of the patient and an increase in the attention to cost containment. (Panzarino PJ et al 1994)
Many authorities agree that this change in focus has shifted the emphasis of patient care to acute stabilisation rather than appropriate comprehensive primary treatment. Once a patient has been stabilised and brought through their acute crisis, they tend to be passed on to the outpatient providers for continuation of their treatment.(Haywood TW et al 1995).
We shall examine the implications of both of these factors on the incidence and the subsequent implications of readmission in due course. As we shall present and discuss, the evidence in this field is not clear, and in some areas, frankly contradictory. It does appear however, that certain trends can be confidently assumed from the data.
In terms of peer reviewed research and comment on the situation regarding readmissions of the acutely mentally ill patient, we could start our investigation with the paper by Noam Trieman (et al. 1999).
Dissertations - Free Nursing Dissertations
