[Evaluation of extramural gerontopsychiatric treatment. I: On the possibility of clinical ambulatory and partial inpatient treatment of elderly psychiatric patients].

Based on data of a quantitative longitudinal study (one year) in two gerontopsychiatric catchment areas in Northrhine-Westfalia (FRG, City of Bielefeld and the district of Gütersloh) the question is discussed, whether an extramural (i.e. home-based outpatient- and day hospital-) treatment concept can be realized without selection of patients by diagnoses or severity of their mental disorders and that of their need of care. These three variables, which are important indicators of the necessary quality and quantity of treatment as well as of care for the patients, are surveyed. In three analytic steps the distribution of the gerontopsychiatric research population--concerning these three variables--over the three treatment settings (in-/outpatient and day hospital) in the two catchment areas is compared. For the district of Gütersloh--with an institution specialized on extramural treatment (the Gerontopsychiatric Center with a combination of a clinical outpatient service and a day hospital) the findings proof, that outpatient--in comparison with inpatient treatment--does not select patients by diagnoses nor by severity of their mental disorders nor by severity of their need of care. The outpatient service in Gütersloh--and nearly in the same degree the day hospital there--can actually integrate older patients with a higher severity of psychiatric symptoms and need of care in average than the inpatient departments in the two clinical gerontopsychiatric units under research.