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dc.contributor.authorSmith, Pen_US
dc.contributor.authorNicaise, Pen_US
dc.contributor.authorGiacco, Den_US
dc.contributor.authorBird, VJen_US
dc.contributor.authorBauer, Men_US
dc.contributor.authorRuggeri, Men_US
dc.contributor.authorWelbel, Men_US
dc.contributor.authorPfennig, Aen_US
dc.contributor.authorLasalvia, Aen_US
dc.contributor.authorMoskalewicz, Jen_US
dc.contributor.authorPriebe, Sen_US
dc.contributor.authorLorant, Ven_US
dc.date.accessioned2019-01-08T08:45:28Z
dc.date.available2018-12-10en_US
dc.date.issued2018-12-21en_US
dc.identifier.urihttps://qmro.qmul.ac.uk/xmlui/handle/123456789/54164
dc.description.abstractBACKGROUND: In Europe, at discharge from a psychiatric hospital, patients with severe mental illness may be exposed to one of two main care approaches: personal continuity, where one clinician is responsible for in- and outpatient care, and specialisation, where various clinicians are. Such exposure is decided through patient-clinician agreement or at the organisational level, depending on the country's health system. Since personal continuity would be more suitable for patients with complex psychosocial needs, the aim of this study was to identify predictors of patients' exposure to care approaches in different European countries. METHODS: Data were collected on 7302 psychiatric hospitalised patients in 2015 in Germany, Poland, and Belgium (patient-level exposure); and in the UK and Italy (organisational-level exposure). At discharge, patients were exposed to one of the care approaches according to usual practice. Putative predictors of exposure at patients' discharge were assessed in both groups of countries. RESULTS: Socially disadvantaged patients were significantly more exposed to personal continuity. In all countries, the main predictor of exposure was the admission hospital, except in Germany, where having a diagnosis of psychosis and a higher education status were predictors of exposure to personal continuity. In the UK, hospitals practising personal continuity had a more socially disadvantaged patient population. CONCLUSION: Even in countries where exposure is decided through patient-clinician agreement, it was the admission hospital, not patient characteristics, that predicted exposure to care approaches. Nevertheless, organisational decisions in hospitals tend to expose socially disadvantaged patients to personal continuity.en_US
dc.description.sponsorshipEuropean Commission’s 7th Framework Programm.e Grant agreement number 602645.en_US
dc.format.extent69 - 74en_US
dc.languageengen_US
dc.language.isoenen_US
dc.relation.ispartofEur Psychiatryen_US
dc.rights(c) 2018. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/
dc.subjectAccessibilityen_US
dc.subjectEuropeen_US
dc.subjectMental health careen_US
dc.subjectPersonal continuityen_US
dc.subjectSpecialisationen_US
dc.titlePredictors of personal continuity of care of patients with severe mental illness: A comparison across five European countries.en_US
dc.typeArticle
dc.identifier.doi10.1016/j.eurpsy.2018.12.003en_US
pubs.author-urlhttps://www.ncbi.nlm.nih.gov/pubmed/30583254en_US
pubs.notesNot knownen_US
pubs.publication-statusPublished onlineen_US
pubs.volume56en_US
dcterms.dateAccepted2018-12-08en_US
rioxxterms.funderDefault funderen_US
rioxxterms.identifier.projectDefault projecten_US


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