Medical psychiatry units:Standardization versus variaton

This thesis aims to provide insight into what an MPU can look like, how to decide which patients should be admitted to an MPU, and how to measure the quality of an MPU. These aims translate into 3 research questions: Question 1: What characterizes the geographical spread, organizational structure, and quality of contemporary MPUs in the Netherlands and the United States? This question is answered in Chapter 2 and Chapter 3. Chapter 2 is titled Medical Psychiatric Units in the Netherlands: an investigation into distribution and quality. Chapter 3 is titled Variation in structural characteristics among twenty Medical Psychiatry Units in the United States: a survey-based study. Question 2: What patient, staff, and organizational factors are pivotal in the decision- making process regarding admissions to MPUs? Chapters 4 and 5 answer this question. Chapter 4 is titled Need analysis for a new high acuity Medical Psychiatry Unit: which patients are considered for admission? Chapter 5 is titled Factors influencing the admission decision for Medical Psychiatry Units: a concept mapping approach. Question 3: How is the quality of care within general hospital psychiatry perceived and defined by patients, healthcare professionals, and funding entities? This question is answered in Chapter 6: Identifying value-based quality indicators for general hospital psychiatry.