Hostname: page-component-cd9895bd7-gbm5v Total loading time: 0 Render date: 2024-12-22T18:06:58.706Z Has data issue: false hasContentIssue false

The birth of a specialty: the first ten thousand patients of an old age psychiatry service

Published online by Cambridge University Press:  29 June 2006

A. Macdonald
Affiliation:
Institute of Psychiatry, London, U.K.
C. Ball
Affiliation:
Institute of Psychiatry, London, U.K.
S. Burton
Affiliation:
Institute of Psychiatry, London, U.K.
J. Herzberg
Affiliation:
East London and The City Mental Health NHS Trust, Mile End Hospital, London, U.K.
E. Murphy
Affiliation:
North East London Strategic Health Authority, Aneurin Bevan House, London, U.K.
M. Philpot
Affiliation:
MHOA Services, South London and Maudsley NHS Trust, The Maudsley Hospital, London, U.K.
R. Rao
Affiliation:
MHOA Services, South London and Maudsley NHS Trust, The Maudsley Hospital, London, U.K.
Get access

Abstract

Background: Old age psychiatry as a clinical specialty emerged in the 1970s and modern, open-access multidisciplinary services started in the mid-1980s in South London. There are few accounts of referrals to old age psychiatry services and no quantitative accounts of the referral patterns to such teams. We report on the first 10,000 patients newly referred to the first such service in the world.

Methods: Observational study on routinely gathered data on age, gender, referral source, discipline of team member involved, diagnosis and duration of contact. Data validation was by iterative feedback to clinicians.

Results: Ten thousand patients were referred between December 1983 and March 2000. Missing data rates were low. The overall referral rate was 21.0 per 1000 population over 65 per annum, with the highest rate in those 85+ years old, in whom there was a marked rise over time. The rise in referral rate compensated for a decline in the population over 65 so that the numbers of referrals rose. Although there was a rise in the rate of referral of people with an organic diagnosis over time, this was not statistically significant. Organic patients constituted 50–60% of referrals but had shorter contact times than functional ones. Cause for concern included a low rate of referral from care homes, and a high proportion of possibly inappropriate referrals from medical and general psychiatry services. We were pleased to see no excess of such referrals from open-access sources, confirming earlier work.

Conclusions: Descriptive data on referrals and workload of the first open-access multidisciplinary old age psychiatry service have generated cause for both celebration and concern.

Type
Research Article
Copyright
International Psychogeriatric Association 2006

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)