Objectives. To establish trends in the prevalence of long-term care provision; an attempt to explain the causes of this phenomenon territorial differentiation, and seeking an answer to the question concerning the so-called trans-institutionalization, i.e. whether psychiatric patients are transferred from mental hospitals to residential care facilities and nursing homes.
Method. The long-term patient populations studied in consecutive years comprise three subgroups: patients hospitalized for at least a year at a mental hospital or psychiatry department, patients staying at nursing homes at the end of year, and those staying at residential care/treatment facilities at the end of year. In the analysis of causes of territorial differentiation 7 independent variables were taken into account, and Spearman's rho coefficient was used to establish correlations.
Results. The prevalence rates of long-term psychiatric inpatients have increased from 66 to 81 per 100 000 population in the years 1992-2005. The contribution of inpatient treatment facilities has decreased from 43%o to 11%o, while the proportion of nursing home residents has risen from 57% to 74%o; many patients have been transferred to long-term residential care/treatment units. The prevalence rates show a considerable territorial differentiation: the highest rates often are twice as high as the lowest ones. The territorial differentiation to some extent depends on the size of rural population in the province, but is not related either to the economic situation in the region or to accessibility of the following facilities: day hospitals and mobile community teams, community self-help homes for the mentally ill, nursing homes for the aged, and shelters for the homeless.
Conclusions. The prevalence rate of long-term inpatients has increased by 21%o over the 13 years under study. The so-called transinstitutionalization is obviously progressing. The lowest prevalence rates are noted in the Mazovian and Pomeranian regions, while the highest - in the Łódzkie and Świętokrzyskie provinces. The prevalence is to a small degree only associated with the size of rural population in a given province.