Using a Mixed Methods Approach to Examine the Effectiveness of Inpatient Rehabilitation Services Following a Programme of Planned Bed Closures

Abstract

This study examined inpatient rehabilitations service in one area in England following a programme of planned bed closures in parts of the service. The study examined changes to admission rates and length of stay in the parts of the service that existed prior to and after the bed closure programme. A mixed method evaluation design was used. Quantitative data relating to admissions and length of inpatients stays bed days was compared for the 3 years up to the bed closures and for the 3 years afterwards. Similarly use of mental health sections for service users being admitted, and contacts with community mental health teams were also compared for the same 3-year pre and post period. Qualitative data from service users, carers of service users, and staff were analyzed thematically to provide an insight into any changes in rehabilitation service usage as a result of the closure programme. In the rehabilitation services that existed before and after bed closures in other parts of the service quantitative findings showed a significant reduction post-rehabilitation stay in all measures except contact with community teams. Qualitative analysis revealed that this is because rehabilitation enables a successful transition into the community and allows for effective relationships to be built between staff and service user. The reduction seen in service utilization suggests rehabilitation has the potential to reduce the revolving door to inpatient metal health care.