The Qualyop Project 1: Monitoring the dismantlement of Italian public psychiatric hospitals. Characteristics of patients scheduled for discharge

Objectives Monitoring and evaluating the Italian psychiatric hospitals clos ure process, stated by the law to be concluded by 31 December 1996, and the n postponed to 31 March 1998, identifying characteristics related to the po ssibility of discharge in 4493 patients living in twentytwo public psychiat ric hospitals. Method Sociodemographic and clinical data, information on impairment and fu nctioning and plans for discharge in the subsequent twelve months of all pa tients were collected at baseline using a standard questionnaire. Results Discharge was planned within twelve months for 11% of the patients: 4% to other psychiatric or non-psychiatric institutions and 7% to communit y settings. Severely disabled patients and patients with some behavioural p roblems were more frequently scheduled to go to institutional settings. For both types of discharge, an adequate network of social relationships was a n important determinant. Patients were more frequently planned for discharg e if they resided in hospitals with a higher care providers/patients ratio, and in Emilia Romagna and Pome, than in Lombardy and Liguria. Conclusion Frequency of planned discharge depended partly on the patients' personal characteristics related to independence and functioning, but the e ffect of these factors on frequency of planned discharge was influenced by characteristics of the hospitals where the patients lived.