The Role Transition and Development Direction of the Psychiatric Day Hospital in General Hospital : Introduction of Day Intensive Care Center

Yong Min Ahn; Hyo Jung Choi; Jae Wook Han; Sun Joo Jang; In Kyoon Lyoo; Jun Soo Kwon

doi:10.4306/jknpa.2013.52.1.17

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Ahn, Choi, Han, Jang, Lyoo, and Kwon: The Role Transition and Development Direction of the Psychiatric Day Hospital in General Hospital : Introduction of Day Intensive Care Center

Review Article

Journal of Korean Neuropsychiatric Association

Journal of Korean Neuropsychiatric Association 2013; 52(1): 17-25.

Published online: 31 January 2013

DOI: https://doi.org/10.4306/jknpa.2013.52.1.17

The Role Transition and Development Direction of the Psychiatric Day Hospital in General Hospital : Introduction of Day Intensive Care Center

Yong Min Ahn, MD, PhD^1,², Hyo Jung Choi, MD², Jae Wook Han, MD², Sun Joo Jang, RD, PhD², In Kyoon Lyoo, MD, PhD^1,², Jun Soo Kwon, MD, PhD^1,²

¹Department of Psychiatry and Behavioral Science and Institute of Human Behavioral Medicine, Seoul National University College of Medicine, Seoul, Korea.

²Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Korea.

Address for correspondence: Jun Soo Kwon, MD, PhD. Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 110-744, Korea. Tel +82-2-2072-2972, Fax +82-2-747-9063, kwonjs@snu.ac.kr

Received 10 July 2012 Revised 21 November 2012 Accepted 2 January 2013

Abstract

The role of the day hospital as a mediator between psychiatric ward admission and return to the community has been weakening in general hospitals. The purpose of this paper is to suggest new developmental directions for the day hospital in general hospitals. The history and the operation model of day hospitals were investigated through a bibliographic search. The national mental health care system and the operational realities of the day hospital were also reviewed. The Seoul National University Hospital (SNUH) Day intensive care center (DICC) was introduced ; we then observed several indexes of the SNUH day hospital before and after the institution of DICC. The number of national community mental health care centers is increasing, and the role of this center is similar to the role of the day hospital. The SNUH day hospital invented a short-term intensive care program named DICC for patients with obsessive compulsive disorder, panic and mood disorders and showed marked increment of the number of patients and income after introduction of the DICC. There might be some benefits in introduction of the DICC to psychiatric day hospitals. The role of the DICC will be highlighted in general hospitals, not only for improvement of day hospital management, but also to help patients through early intervention.

Keywords: DICC, Day hospital, Early intervention

Figures and Tables

Fig. 1

Scale change in OCD patients before and after admission. OCD : Obsessive compulsive disorder, YBOCS : Yale-Brown Obsessive Compulsive Scale, BDI : Beck Depression Inventory, BAI : Beck Anxiety Inventory, HAMD : Hamilton Depression Rating Scale, HAMA : Hamilton Anxiety Rating Scale, CGI-S : Clinical Global Impression-Severity, Baseline : Scale score at admission, End : Scale score at discharge. n=78.

Fig. 2

Scale change in panic disorder patients before and after admission. PDSS : Panic Disorder Severity Scale, baseline : Scale score at admission. n=s12.

Fig. 3

Scale change in mood disorder patients before and after admission. BDI : Beck Depression Inventory, BDRS : Brief Depression Rating Scale, MADRS : Montgomery Asberg Depression Rating Scale, CGI-S : Clinical Global Impression-severity, Baseline : Scale score at admission, Week 2 : Scale score at discharge. n=41.

Fig. 4

Change in the number of day hospital patients. DICC : Day Intensive Care Center.

Table 1

Day hospital utilization rate and number of day hospital bed per 100 thousands people

Central mental health service support group business report, 2009

Table 2

Number of day hospital bed and utilization rate in each cities and provinces and according to the type of mental health care institution at 2009

Central mental health sevice support group business report, 2009

Table 3

Demographic characteristics of DICC patient (2011.10-2012.4)

DICC : Day Intensive Care Center, OCD : Obsessive compulsive disorder, SD : Standard deviation

Notes

The authors have no financial conflicts of interest.

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