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Observed Outcomes: An Approach to Calculate the Optimum Number of Psychiatric Beds

  • Richard O’ReillyEmail author
  • Stephen Allison
  • Tarun Bastiampiallai
Original Article

Abstract

The number of psychiatric beds, in most developed countries, has decreased progressively since the late 1950s. Many clinicians believe that this reduction has gone too far. But how can we determine the number of psychiatric beds a mental health system needs? While the population health approach has advantages over the normative approach, it makes assumptions about optimal and minimum duration of hospitalization required for various psychiatric disorders. In this paper, we describe a naturalistic approach that estimates the required number of psychiatric beds by comparing the bed levels at which negative outcomes develop in different jurisdictions. We hypothesize that there will be a threshold below which negative outcomes will be seen across jurisdictions. We predict that hospital key performance indices will be more sensitive to bed reductions than the clinical and social outcomes of patients. The observed outcome approach can complement other approaches to determining bed numbers at the national and local levels, and should be a priority for future health services research.

Keywords

Psychiatric beds Deinstitutionalization Health services research 

Notes

Funding

This study did not receive any funding.

Compliance with Ethical Standards

Conflict of interest

The authors have no conflicts of interest related to this article.

Ethical Approval

This article does not contain any studies with human participants or animals performed by any of the authors.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Richard O’Reilly
    • 1
    Email author
  • Stephen Allison
    • 2
  • Tarun Bastiampiallai
    • 2
  1. 1.Department of Psychiatry, Schulich School of Medicine & Dentistry, St. Joseph’s Health Care LondonWestern UniversityLondonCanada
  2. 2.Department of Psychiatry, College of Medicine and Public HealthFlinders UniversityAdelaideAustralia

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