Purpose Psychiatric emergency hospital admissions for distinct psychiatric disorders and length of inpatient stay in the hospital during the Coronavirus disease 2019 (COVID-19) outbreak have not been thoroughly assessed. Methods A retrospective study was performed analyzing claims data from a large German Hospital network during the COVID-19 outbreak (study period: March 13–May 21, 2020) as compared to periods directly before the outbreak (same year control: January 1–March 12, 2020) and one year earlier (previous year control: March 13–May 21, 2019). Results A total of 13,151 emergency hospital admissions for psychiatric diagnoses were included in the analysis. For all psychiatric diagnoses combined, emergency admissions significantly decreased during the study period with mean (interquartile range) incidence rate ratios (IRRs) of 0.68 (0.65, 0.71) and 0.70 (0.67, 0.73) as compared to the same and previous year controls, respectively (both p < 0.00001). IRR ranged from 0.56 for mood affective disorders (F30-F39) to 0.75 for mental disorders due to psychoactive substance use (F10-F19; all p < 0.00001). Mean (standard deviation) length of hospital stay for all psychiatric diagnoses was significantly shorter during the study period [9.8 (11.6) days] as compared to same [14.7 (18.7) days] and previous [16.4 (23.9) days] year controls (both p < 0.00001). Conclusion Both emergency hospital admissions and length of hospital stay significantly decreased for psychiatric disorders during the COVID-19 outbreak. It needs to be assessed in further studies whether healthcare systems will face increased demand for the provision of mental health care in the nearer future. Supplementary Information The online version contains supplementary material available at 10.1007/s00127-021-02091-z.
The impact of COVID-19 on urgent and involuntary inpatient admissions, as well as coercive measures, has not been assessed so far. A retrospective study was performed analyzing claims data for inpatient psychiatric admissions between 2018 and 2020 (total n = 64,502) from a large German Hospital network. Whilst the total number of urgent admissions decreased in 2020 (12,383) as compared to 2019 (13,493) and 2018 (13,469), a significant increase in the percentage of urgent admissions was observed in 2020 (62.9%) as compared to 2019 (60.6%) and 2018 (59.7%). Compared to this study period, Odds ratio (OR) for proportion were 0.87 (0.84, 0.91) and 0.91 (0.87, 0.95) for 2018 and 2019, respectively (both p < 0.00001). Percentage of involuntary psychiatric admissions also significantly increased in 2020 and OR compared to this study period ranged from 0.86 (0.81, 0.93) in 2019 (p < 0.0001) to 0.88 (0.82, 0.95) in 2018 (p < 0.001). Proportion of coercive measures significantly increased in 2020 as compared to 2019 (p = 0.004). Taken together, the present study shows an increase in the proportion of involuntary and urgent psychiatric admissions during the whole pandemic year 2020 as compared to 2018 and 2019. The long-term impact of these COVID-19 pandemic-related trends on psychiatric health care needs to be assessed in further studies.
Zusammenfassung Ziel der Studie Die Auswirkungen der COVID-19-Pandemie in 2020 auf die Anzahl der täglichen psychiatrischen Notfallaufnahmen und die stationäre psychiatrische Aufenthaltsdauer wurde mit Vorjahren verglichen. Methodik In einer retrospektiven Studie wurden die 4 Quartale 2020 mehrerer psychiatrischer Kliniken in Deutschland mit den jeweiligen Quartalen von 2018 und 2019 statistisch verglichen. Ergebnisse Insgesamt wurden 73 412 Fälle analysiert. Im 2. Quartal 2020 war die Zahl der täglichen Aufnahmen mit 59,1 signifikant niedriger im Vergleich zum Kontrollzeitraum mit 70,7 (Inzidenzratenverhältnis [95 %-Konfidenzintervall] 0,81 [0,69; 0,96]; p = 0,012). Die Aufenthaltsdauer war zwischen allen Quartalen 2020 im Vergleich zum Kontrollzeitraum numerisch, aber nicht signifikant unterschiedlich. Schlussfolgerung Die COVID-19-Pandemie zeigt deutliche Auswirkungen auf die stationäre psychiatrische Versorgung. Zukünftig muss der Blick stärker auf die Notfall- und Krisenversorgung psychisch erkrankter Menschen gelenkt werden.
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