[Developments in Psychiatric Care from 2005 to 2022: A Retrospective, Longitudinal Analysis of Hospital Data on 110,996 Inpatient Cases].

Abstract

The prevalence of mental disorders is 27.8% among the adult population in Germany. Although psychiatric clinics play a central role in the care of these patients, the extensive, digitally collected routine data are rarely systematically evaluated. This study characterises the patient population of a large psychiatric clinic and analyses constants as well as developments in inpatient psychiatric care over an 18-year period.The retrospective analysis was based on longitudinal data from the hospital information system of the Evangelische Stiftung Tannenhof, which operates psychiatric clinics in urban regions of the Bergisches Land. Anonymised data from 110,996 fully inpatient cases from the years 2005 to 2022 were included in the analysis. The study examined demographic characteristics, length of stay, psychiatric main discharge diagnoses, somatic comorbidities, and the development of prescribed medications.The gender ratio and age structure of the patients remained largely constant over the entire period. Diagnostically, there was a slight increase in psychotic disorders and organic psychiatric disorders, while substance use disorders slightly decreased. A significant increase was observed in somatic comorbidities and the number of prescribed medications, with somatic medication increasing disproportionately compared to psychiatric medication. The COVID-19 pandemic led to a significant increase in Z-diagnoses, indicating a need for action from a somatic perspective.The retrospective data analysis showed that demographic characteristics and diagnostic patterns remained largely stable. Meanwhile, the complexity of medication and the number of somatic comorbidities increased. These developments emphasise the growing need for expertise in both somatic and psychiatric medication in clinical practice. Significant short-term changes in the data across the entire clinic only occurred during major events, namely the integration of a new larger addiction clinic and the COVID-19 pandemic. The results underscore the value of routine data in optimising care strategies in inpatient psychiatry.