Medical care for chronic ambulatory patients: a follow-up
The central theme of the study described in this paper is the improvement of the monitoring and care of physical health of ambulatory chronic psychiatric patients. The first part of this study describes a screening on physical illness and complaints in 156 chronic psychiatric outpatients of an urban Community Psychiatric Unit (CPU). The percentage of patients with one or more physical diseases during three years follow-up proved to be 36% instead of the initially found 53%. The majority of physical complaints and diseases were chronic. The physical screening in 1986/'87 produced 35% false positives and 11% false negatives.
The initial conclusion that the majority of detected physical illnesses were minor and could well be treated by a G.P., still holds three years later. Morbidity patterns, previously found high frequency of patient-visits to the primary care team and follow-up of the physical screening, suggest that a well organized primary care team with the patient's G.P. as the primary responsible physician for the patients physical health, is a good alternative to a regular routine medical screening.