Outpatient visits and hospital discharges of depression and schizophrenia patients in mental health facilities, 2014 – 2019: a sampling survey across China

Abstract

ObjectiveTo examine person-times and proportion of outpatient visits and hospital discharges for depression and schizophrenia patients in mental health facilities across China during 2014 – 2019 for providing evidence to improve the allocation of mental health services in China. MethodsUsing stratified sampling, we conducted a survey among 46 provincial- and 36 prefecture-level mental health facilities in 31 provincial-level administrative divisions across China from November 2020 to February 2021. A self-designed questionnaire was used to collect the facilities′ data on outpatient visits and hospital discharges for all patients and those diagnosed with depression and schizophrenia (with the International Statistical Classification of Diseases and Related Health Problems, 10th Revision [ICD-10] codes of F32 and F33) during the period from 2014 through 2019. ResultsEligible responses were collected from 74 mental health facilities, in which, 40 (54.05%) were at provincial-level and 34 (45.95%) at prefecture-level, including 45 psychiatric hospitals and 29 psychiatric departments in general hospitals. During the period from 2014 to 2019 for all the facilities surveyed, significant increase was observed in the proportion of outpatient visits (person-times) by depression patients against all other patients (4.28% to 7.63%, χ2trend = 144 209.17; P < 0.001) and in the proportion of hospital discharges (person-times) of depression patients against all other patients (4.92% to 7.10%, χ2trend = 3 754.42; P < 0.001); but there was significant decrease in the proportion of outpatient visits by schizophrenia patients (13.34% to 10.53%, χ2trend = 73 411.23; P < 0.001 ) and in the proportion of hospital discharges of schizophrenia patients (18.87% to 16.82%, χ2trend = 1 573.79; P < 0.001). Throughout the 6-year period compared to those for the facilities at prefecture-level, all the annual proportion of the outpatient visits by depression patients were significantly higher for the facilities at provincial-level but the annual proportion of the outpatient visits by schizophrenia patients were significantly lower (all P < 0.001); all the annual proportion of hospital discharges of both depression and schizophrenia patients were significantly lower for the facilities at provincial-level (all P < 0.001). When compared to those for the psychiatry departments of general hospitals, all the annual proportions of outpatient visits by depression and schizophrenia patients and all the annual proportions of hospital discharges of depression and schizophrenia patients were significantly higher for the psychiatric hospitals over the 6-year period (all P < 0.001). ConclusionDuring the period from 2014 to 2019 for the mental health facilities in China, the annual proportions of depression patients′ outpatient visits and hospital discharges showed an increasing trend but those of schizophrenia patients′ showed a decreasing trend. The study results should be concerned in allocation of health resources for mental healthcare.

Keywords

• depression
• schizophrenia
• outpatient visits
• discharges
• mental health facilities