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Evidence summaries

Day Hospital Versus Admission for Acute Psychiatric Disorders

Acute day hospitals appear to be as effective as inpatient care in treating acutely ill psychiatric patients. Level of evidence: "B"

A Cochrane review (abstract , review [Abstract]) included 10 studies with a total of 2685 people. There was no difference in the number lost to follow-up by one year between day hospital care and inpatient care (RR 0.94, CI 0.82 to 1.08; 5 RCTs, n = 1694). The duration of index admission is longer for patients in day hospital care than inpatient care (WMD 27.47, CI 3.96 to 50.98; 4 RCTs, n = 1582). The duration of day patient care (adjusted days/month) is longer for patients in day hospital care than inpatient care (WMD 2.34, days/month CI 1.97 to 2.70; 3 RCTs, n = 265). However, there is no difference between day hospital care and inpatient care for the being readmitted to in/day patient care after discharge (RR 0.91, CI 0.72 to 1.15; 5 RCTs, n = 667). There is no difference either between day hospital care and inpatient care for being unemployed at the end of the study (RR 0.88, CI 0.66 to 1.19; 1 RCT, n = 179), for quality of life (MD 0.01, CI -0.13 to 0.15; 1 RCT, n = 1117) or for treatment satisfaction (MD 0.06, CI -0.18 to 0.30; 1 RCT, n = 1117).

Comment: The quality of evidence is downgraded by study quality (more than 20% loss to follow-up).

    References

    • Marshall M, Crowther R, Almaraz-Serrano A, Creed F, Sledge W, Kluiter H, Roberts C, Hill E, Wiersma D. Day hospital versus admission for acute psychiatric disorders. Cochrane Database Syst Rev 2003;(1):CD004026. [Assessed as up-to-date: 17 Feb 2011][PubMed]

Primary/Secondary Keywords