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.