Long-term care. A cohort study using the Portoguaro Case Register

Objective – The aim of this paper is to analyse long-term care in an area (Portogruaro) monitorized with a Psychiatric Case Register. Design – A cohort composed by patients included in 1987 prevalence was followed in 1992. Three hypothesis have been tested: a) long-term patients (LT) have a better prognosis than long-stay patients; b) clinical and socio-demographical characteristics of LT are significantly different from those of non-LT patients included in the cohort; c) clinical and socio-demographical characteristics of LT that are also high-users are different from those LT that are not high-users. Main outcome measures – Analysis was performed using generalised linear models; principal clinical and socio-demographical characteristics were considered. Results – The results confirm the first hypothesis, and show that two variables (previous psychiatric contact and employment) were associated with patterns of care in 1992. Highly significant is the correlation between patterns of contacts in 1987 and 1992, showing that particularly long-term and high-user patients tend to confirm their pattern over the years. Conclusions – These results underline the necessity for psychiatric services to commit themselves to the care of this group of patients, that constitute the «new chronicity».