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Emergency department presentation and readmission after index psychiatric admission: a data linkage study

OBJECTIVE: To use linked administrative datasets to assess factors associated with emergency department (ED) presentation and psychiatric readmission in three distinctive time intervals after the index psychiatric admission. DESIGN: A retrospective data-linkage study. SETTING: Cohort study using fou...

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Autores principales: Li, Xue, Srasuebkul, Preeyaporn, Reppermund, Simone, Trollor, Julian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5855390/
https://www.ncbi.nlm.nih.gov/pubmed/29490956
http://dx.doi.org/10.1136/bmjopen-2017-018613
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author Li, Xue
Srasuebkul, Preeyaporn
Reppermund, Simone
Trollor, Julian
author_facet Li, Xue
Srasuebkul, Preeyaporn
Reppermund, Simone
Trollor, Julian
author_sort Li, Xue
collection PubMed
description OBJECTIVE: To use linked administrative datasets to assess factors associated with emergency department (ED) presentation and psychiatric readmission in three distinctive time intervals after the index psychiatric admission. DESIGN: A retrospective data-linkage study. SETTING: Cohort study using four linked government minimum datasets including acute hospital care from July 2005 to June 2012 in New South Wales, Australia. PARTICIPANTS: People who were alive and aged ≥18 years on 1 July 2005 and who had their index admission to a psychiatric ward from 1 July 2007 to 30 June 2010. OUTCOME MEASURES: ORs of factors associated with psychiatric admission and ED presentation were calculated for three intervals: 0–1 month, 2–5 months and 6–24 months after index separation. RESULTS: Index admission was identified in 35 056 individuals (51% -males) with a median age of 42 years. A total of 12 826 (37%) individuals had at least one ED presentation in the 24 months after index admission. Of those, 3608 (28%) presented within 0–1 month, 6350 (50%) within 2–5 months and 10 294 (80%) within 6–24 months after index admission. A total of 14 153 (40%) individuals had at least one psychiatric readmission in the first 24 months. Of those, 6808 (48%) were admitted within 0–1 month, 6433 (45%) within 2–5 months and 7649 (54%) within 6–24 months after index admission. Principal diagnoses and length of stay at index admission, sociodemographic factors, Charlson Comorbidity Index score, drug and alcohol comorbidity, intellectual disability and other inpatient service use were significantly associated with ED presentations and psychiatric readmissions, and these relationships varied somewhat over the intervals studied. CONCLUSION: Social determinants of service use, drug and alcohol intervention, addressing needs of individuals with intellectual disability and recovery-oriented whole-person approaches at index admission are key areas for investment to improve trajectories after index admission.
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spelling pubmed-58553902018-03-19 Emergency department presentation and readmission after index psychiatric admission: a data linkage study Li, Xue Srasuebkul, Preeyaporn Reppermund, Simone Trollor, Julian BMJ Open Health Services Research OBJECTIVE: To use linked administrative datasets to assess factors associated with emergency department (ED) presentation and psychiatric readmission in three distinctive time intervals after the index psychiatric admission. DESIGN: A retrospective data-linkage study. SETTING: Cohort study using four linked government minimum datasets including acute hospital care from July 2005 to June 2012 in New South Wales, Australia. PARTICIPANTS: People who were alive and aged ≥18 years on 1 July 2005 and who had their index admission to a psychiatric ward from 1 July 2007 to 30 June 2010. OUTCOME MEASURES: ORs of factors associated with psychiatric admission and ED presentation were calculated for three intervals: 0–1 month, 2–5 months and 6–24 months after index separation. RESULTS: Index admission was identified in 35 056 individuals (51% -males) with a median age of 42 years. A total of 12 826 (37%) individuals had at least one ED presentation in the 24 months after index admission. Of those, 3608 (28%) presented within 0–1 month, 6350 (50%) within 2–5 months and 10 294 (80%) within 6–24 months after index admission. A total of 14 153 (40%) individuals had at least one psychiatric readmission in the first 24 months. Of those, 6808 (48%) were admitted within 0–1 month, 6433 (45%) within 2–5 months and 7649 (54%) within 6–24 months after index admission. Principal diagnoses and length of stay at index admission, sociodemographic factors, Charlson Comorbidity Index score, drug and alcohol comorbidity, intellectual disability and other inpatient service use were significantly associated with ED presentations and psychiatric readmissions, and these relationships varied somewhat over the intervals studied. CONCLUSION: Social determinants of service use, drug and alcohol intervention, addressing needs of individuals with intellectual disability and recovery-oriented whole-person approaches at index admission are key areas for investment to improve trajectories after index admission. BMJ Publishing Group 2018-02-28 /pmc/articles/PMC5855390/ /pubmed/29490956 http://dx.doi.org/10.1136/bmjopen-2017-018613 Text en © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted. This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
spellingShingle Health Services Research
Li, Xue
Srasuebkul, Preeyaporn
Reppermund, Simone
Trollor, Julian
Emergency department presentation and readmission after index psychiatric admission: a data linkage study
title Emergency department presentation and readmission after index psychiatric admission: a data linkage study
title_full Emergency department presentation and readmission after index psychiatric admission: a data linkage study
title_fullStr Emergency department presentation and readmission after index psychiatric admission: a data linkage study
title_full_unstemmed Emergency department presentation and readmission after index psychiatric admission: a data linkage study
title_short Emergency department presentation and readmission after index psychiatric admission: a data linkage study
title_sort emergency department presentation and readmission after index psychiatric admission: a data linkage study
topic Health Services Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5855390/
https://www.ncbi.nlm.nih.gov/pubmed/29490956
http://dx.doi.org/10.1136/bmjopen-2017-018613
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