[Frequency and coding of psychiatric care of short-stay patients]. / Fréquence et codage des prises en charge psychiques des patients hospitalisés en court séjour.

INTRODUCTION: The objective of this study was to describe the frequency and coding of the psychiatric management of short-stay patients admitted to Nice University Hospital in 2013. METHODS: Various parameters were measured : percentage of outpatient psychiatric procedures or psychiatric diagnosis codes ; coding practice differences between the Programme de médicalisation des systèmes d'information (Medical Information System Programme) for medicine, surgery and obstetrics and psychiatric medical data records, and the impact of coding on diagnosis-related groups. RESULTS: Twenty-four per cent of hospitalised patients received psychiatric management (either outpatient care or a psychiatric diagnosis) and 3.9% received both psychiatric management and a psychiatric diagnosis. Liaison psychiatrists more commonly used codes for neurotic and psychosomatic disorders (28% vs 16%), while somatic physicians more commonly used codes for psychoactive substance use-related disorders (26% vs 16%).The presence of psychiatric comorbidity had an impact on the DRG classification or the level of severity for 0.5% of standardized discharge summaries. CONCLUSION: This study illustrates the importance of the active involvement of psychiatry personnel in the management of short-stay patients. The importance of psychosomatic medicine in a short-stay institution could be improved by establishing a clearer definition of coding rules for these diseases and revising and identifying wards or beds devoted to psychosomatic disorders.

[A comparative study of coding and information systems for the evaluation of medical and social conditions: the case of addictive disorders]. / Étude comparative de systèmes de codage pour l'évaluation des situations médicales et sociales : le cas des troubles addictifs.

The purpose of this study was to conduct a descriptive and comparative analysis of the tools used by healthcare professionals specializing in addictive disorders to promote a rapprochement of information systems. The evaluation guide used to assess the compensation needs of disabled persons treated in "Maisons Départementales des Personnes Handicapées" (centres for disabled people) organizes information in different areas, including a psychological component. The guide includes social and environmental information in the "Recueil Commun sur les Addictions et les Prises en charges" (Joint Report on Drug Addiction and Drug Treatment). While the program for the medicalization of information systems includes care data, the current information about social situations remains inadequate. The international classification of diseases provides synthetic diagnostic codes to describe substance use, etiologic factors and the somatic and psychological complications inherent to addictive disorders. The current system could be radically simplified and harmonized and would benefit from adopting a more individualized approach to non-substance behavioral addictions. The international classification of disabilities provides tools for evaluating the psychological component included in the recent definition of addictive disorders. Legal information should play an integral role in the structure of the information system and in international classifications. The prevalence of episodes of care and treatment of addictive and psychological disorders was assessed at Nice University Hospital in all disciplines. Except in addiction treatment units, very few patients were found to have a RECAP file.