Vertex (Buenos Aires, Argentina) · 2026
[Long-Stay Inpatient Care in a Psychiatric Hospital: Three Decades of Transition Toward Community-Based Mental Health Care].
Аннотация на английскомСтатьяНазвание и аннотация: Перевод пока не подготовлен
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Gargoloff Pedro Damián, Moreno Frade Iván O, Gargoloff Pedro Rafael, Valva Juana S
Аннотация
INTRODUCTION: The transition from the asylum-based model to community-based mental health care has led to a sustained reduction in long-stay psychiatric hospitalizations, although important questions remain regarding the characteristics of the population that continues to be institutionalized. The aim of this study was to analyze the evolution of long-stay psychiatric hospitalizations at Dr. Alejandro Korn Hospital, La Plata, Argentina, between 1995 and 2023.
METHODS: An observational, descriptive, comparative, repeated cross-sectional series study was conducted based on four censuses performed in long-stay wards in 1995, 2009, 2021, and 2023.
RESULTS: The number of hospitalized patients declined from 1,048 to 86, while long-stay wards decreased from 23 to 5. The mean age increased from 52.9 to 61.3 years, and the proportion of men rose from 44.2% to 72.1%. Schizophrenia remained the predominant diagnosis (44–53%), whereas the proportion of patients with intellectual disability increased from 28% to 44%. In 2023, 67.4% of patients had been hospitalized for more than 20 years, and 38.4% had remained continuously hospitalized since 1995.
DISCUSSION: Despite the marked reduction in the institutionalized population, a core group of patients with extremely prolonged hospitalizations remained. The study did not assess the trajectories of those who left the hospital between censuses, including community discharges, deaths, and transfers to other institutions, nor the characteristics of the receiving facilities. This limitation precludes determining to what extent the observed reduction reflected processes of deinstitutionalization or, in some cases, may have involved trajectories of transinstitutionalization. Therefore, the reduction in the number of hospitalized individuals represents a relevant dimension of mental health reform but cannot, by itself, be considered equivalent to deinstitutionalization.
METHODS: An observational, descriptive, comparative, repeated cross-sectional series study was conducted based on four censuses performed in long-stay wards in 1995, 2009, 2021, and 2023.
RESULTS: The number of hospitalized patients declined from 1,048 to 86, while long-stay wards decreased from 23 to 5. The mean age increased from 52.9 to 61.3 years, and the proportion of men rose from 44.2% to 72.1%. Schizophrenia remained the predominant diagnosis (44–53%), whereas the proportion of patients with intellectual disability increased from 28% to 44%. In 2023, 67.4% of patients had been hospitalized for more than 20 years, and 38.4% had remained continuously hospitalized since 1995.
DISCUSSION: Despite the marked reduction in the institutionalized population, a core group of patients with extremely prolonged hospitalizations remained. The study did not assess the trajectories of those who left the hospital between censuses, including community discharges, deaths, and transfers to other institutions, nor the characteristics of the receiving facilities. This limitation precludes determining to what extent the observed reduction reflected processes of deinstitutionalization or, in some cases, may have involved trajectories of transinstitutionalization. Therefore, the reduction in the number of hospitalized individuals represents a relevant dimension of mental health reform but cannot, by itself, be considered equivalent to deinstitutionalization.