Availability of doctors in outpatient clinics for substance abuse and for general psychiatry.

BACKGROUND

Substance abusers and psychiatric patients have a high degree of comorbid somatic disorders, are less frequently treated for their somatic disorders and have a high mortality rate. The objective of this study was to examine the availability of medical doctors in outpatient clinics for general psychiatry and for substance abuse, the presence of routines for medical assessment of all patients and of routine collection of blood samples.

MATERIAL AND METHOD

In the period December 2012-May 2013, emails containing five questions were sent to the outpatient clinics in question. An overview of the outpatient clinics was obtained from the websites of the hospital trusts and supplemented with information from the Free Hospital Choice scheme. Altogether 78 general psychiatry outpatient clinics, 39 outpatient clinics for substance abuse and 18 general psychiatry outpatient clinics with a substance abuse team were contacted.

RESULTS

The response rate amounted to 90%. The density of medical doctors (defined as man-years by other professions per man-year by doctors) varied from 1.3 to 140 (average 9.4 and median 5.0). Five per cent of the outpatient clinics reported that all patients saw a doctor during the course of treatment, while 53% reported that all patients were assessed indirectly by a doctor upon admission and/or by an interdisciplinary team/treatment meeting. Altogether 19% of the outpatient clinics routinely collected blood samples at the initiation of treatment.

INTERPRETATION

The results indicate that there are major differences in terms of the availability of doctors and routines for medical assessment and collection of blood samples in outpatient clinics for general psychiatry and for substance abuse.