Inpatient or day clinic treatment? Results of a multi-site-study

OBJECTIVE This naturalistic study aimed to identify criteria which are of relevance for making a decision as to whether inpatient or day hospital treatment is indicated. METHODS In 567 patients who were consecutively admitted to 10 departments of psychosomatic medicine (day hospital or inpatient setting) in Germany, symptom severity at admission and discharge was measured (Symptom-Check-List-90-R, Global Assessment of Functioning). Before admission, clinicians rated aspects that might be important for differential indication (Rating Scale of Indication Criteria). A regression analysis was conducted to reveal relationships between outcome in each setting and possible predictors (criteria of relevance). RESULTS At admission inpatients and day clinic patients already showed some differences referring to aspects clinicians used to select patients for each setting. Good outcome in day hospital patients was associated with a high motivation and higher burdens at home, whereas reduced drive and loss of interest was correlated with a less favourable course. Inpatients did less well if their symptoms were triggered by situations at home and if they showed a high potential for regression. CONCLUSION RESULTS give first hints for criteria which are relevant for making a decision between inpatient and day hospital treatment in psychosomatic medicine.