Psychiatric and social outcomes of a rural district general hospital in the 1990s

This study investigates the psychiatric and social outcomes of treatment by the psychiatric unit of a district general hospital in a semirural region of Australia. The study is a naturalistic investigation of a routine clinical service, and utilizes a longitudinal panel design. Repeat interviews at admission, 1 month and 1 year later were conducted with all consenting respondents (n = 57) with a diagnosis of schizophrenia, bipolar disorder or related condition, as well as with their nominated relatives. Patients showed significant improvements on clinical measures (P < 0.001) and a high rate of continuation of medication. Most measures of social functioning showed improvement although few were statistically significant. Patients and relative satisfaction was high. Relative worry showed significant improvement in the first month (P < 0.05). There was a high rate of readmission (31 patients) and mean days in hospital were also high at 43 days. These results suggest that basic district general hospital care, operating under both budgetary restrictions and the difficulties associated with recruiting staff can nonetheless provide a credible service. However, the results fall short of what research tells us can be achieved when services are adequately funded and more specifically targeted to meet patient needs.