Use of Hospital Services for F40–F48 Disorders in Romania

Abstract

INTRODUCTION. Neurotic, stress-related and somatoform disorders (ICD-
10 F40–F48) represent an important group of mental health conditions associated
with psychosocial stress and significant functional impairment. Analysing
hospital service utilisation for these diagnoses is essential for understanding the
burden on the health system and for informing managerial decisions.
METHODS. A retrospective observational study based on hospital
administrative (DRG-type) data for 2016–2025. Episodes with a principal
diagnosis within ICD-10 F40–F48 were included and identified by aggregating
ICD-10 codes. The analysis used DAX measures in Power Pivot to compute the
number of episodes, unique patients and distributions by year, place of residence
(urban/rural), sex, county, admission type, diagnosis, length of stay and discharge
status.
RESULTS. During the study period, 67,187 hospitalisation episodes with
F40–F48 diagnoses were recorded. The temporal trend shows a sharp decline in
2020 (−50% vs 2019), followed by a gradual recovery through 2025. The urban/
rural distribution was relatively balanced (53.3% urban; 46.7% rural). Women
accounted for 57.6% of episodes. More than half of admissions occurred “without
a referral letter” (55.3%), suggesting predominantly direct access. The most
frequent diagnoses were F41.2 (mixed anxiety and depressive disorder, ~20.5%)
and F43.2 (adjustment disorder, ~11.4%). Most discharges were coded as
“improved” (91.8%), and length of stay was predominantly concentrated in shortto-
medium intervals.
CONCLUSIONS. Hospital service utilisation for F40–F48 disorders was
strongly affected by the pandemic period, followed by a subsequent recovery in
admissions. The high proportion of non-referral admissions and marked
territorial heterogeneity indicate the need to strengthen outpatient and community
mental health services, optimise referral pathways and improve regional resource
planning.