The Nordic comparative study on sectorised psychiatry: repeated emergency admissions to inpatient care during a 1-year follow-up

Author(s): Christiansen, L., Gostas, G., Hakko, H., Lonnerberg, O., Muus, S., Sandlund, M., Oiesvold, T., Hansson, L.

Journal/Book: Eur Psychiat. 1998; 13: 23 Rue Linois, 75724 Paris Cedex 15, France. Editions Scientifiques Medicales Elsevier. 385-391.

Abstract: The emergency admissions to hospital care in six psychiatric services in four Nordic countries were explored as a part of a Nordic comparative study on sectorised psychiatry. One year treated incidence cohorts were used, with the total cohort comprising 2,454 patients. Of the 803 patients who were admitted to inpatient care during a 1 year follow-up, 82% had at least one emergency admission and 23% repeated emergency admissions. The definition for the repeated emergency admissions was at least two admissions during the follow-up. The mean length of stay in emergency inpatient care per treatment episode for this patient subgroup was 28 days. Their emergency inpatient episodes constituted 30% of all inpatient days during the follow-up. However, the variations between the services and diagnostic subgroups were large. The results of a logistic regression analysis indicated that the following variables predicted repeated emergency admissions: inpatient care at index contact, emergency outpatient contacts or no planned hospital admissions during the follow-up, psychiatric service, age under 45 years, and a diagnosis of psychosis, personality disorder or dependency. The repeated emergency admissions were related to the existence of a special service unit for abusers but not to the rates of outpatient staff or acute beds in the services, to geographical distances, referral practice or existence of emergency services.

Note: Article Saarento O, Oulu Univ, Dept Psychiat, FIN-90210 Oulu, FINLAND

Keyword(s): emergency services, psychiatric; follow-up studies; mental health services; REVOLVING-DOOR PATIENTS; TREATED INCIDENCE; SERVICES; COHORT; DISORDERS; RESOURCES; PATTERNS

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