Economic impact of crisis intervention in emergency psychiatry: a naturalistic study

Damsa, Cristian; Hummel, Christopher; Şar, Vedat; Clemente, Thierry Di; Maris, Stella; Lazignac, Coralie; Massarczyk, Odile; Pull, Charles

doi:10.1016/j.eurpsy.2005.05.003

Cited by 20 publications

(15 citation statements)

References 6 publications

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“…Compared with standard care, a multidisciplinary crisis team did not result in different levels of patient distress, 33 whereas crisis intervention by a medical team decreased patient hospitalization (OR, 0.59; 95% CI, 0.43Y0.82). 27 In their evaluation of a computerized reminder system for restraints, Griffey et al 24 …”

Section: Effects Of Other Ed Mental Health Carementioning

confidence: 99%

A Systematic Review of Crisis Interventions Used in the Emergency Department

Hamm

Osmond²,

Curran³

et al. 2010

Pediatric Emergency Care

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Objective-In this systematic review we evaluated the effectiveness of emergency department (ED)-based management interventions for mental health presentations with an aim to provide recommendations for pediatric care.Methods-A search of electronic databases, references, key journals and conference proceedings was conducted and primary authors contacted. Experimental and observational studies that evaluated ED crisis care with pediatric and adult patients were included. Adult-based studies were evaluated for potential translation to pediatric investigation. Pharmacological-based studies were excluded. Inclusion screening, study selection, and methodological quality were assessed by two Conclusions-Pediatric studies have demonstrated that the use of specialized care models for mental health care can reduce hospitalization, return ED visits, and length of ED stay. Evaluation of these models using more rigorous study designs and the inclusion of patient-based outcomes will improve this evidence base. Adult-based studies provided recommendations for pediatric research including a focus on triage and restraint use.

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Section: Effects Of Other Ed Mental Health Carementioning

confidence: 99%

A Systematic Review of Crisis Interventions Used in the Emergency Department

Hamm

Osmond²,

Curran³

et al. 2010

Pediatric Emergency Care

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“…Hospitalization decisions in emergency psychiatry raise ethical and economical questions, especially if we consider that residents are often working in emergency [6]. Interestingly, even the risk of suicide for patients with schizophrenia seems significantly higher for those treated by male psychiatrists than those treated by female psychiatrists [7].…”

Section: Introductionmentioning

confidence: 98%

Are Female Psychiatry Residents Better to Propose in Emergency a Voluntary Hospitalization?

et al. 2009

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This study analyses assessment, intervention and admission decisions made by emergency psychiatry residents, to determine whether these differ depending on the gender of the resident. Data from all patients presenting to a psychiatric emergency room were collected prospectively for a 3 months period as part of a local quality check project. A questionnaire was used to collect patient demographic data, diagnosis, treatment decisions and the personal and professional characteristics of the residents who performed the assessments. During the 3 months of the study period we obtained data on all 251 emergency assessments carried out by all six residents working in the service. These were 3 female and 3 male 3rd year residents in psychiatry. There was no difference between male and female residents concerning ICD-10 diagnostic assessment, adherence to local hospitalization criteria guidelines, psychotherapeutical and pharmacological treatments administered. A similar distribution between male and female residents was found for diagnoses. No difference was found in the rate of hospitalization decisions between male and female residents. However, surprisingly, there were more voluntary hospitalizations by the women residents (P = 0.035; χ2 = 4.443) and more involuntary admissions by the men residents (P = 0.005; χ2 = 7.643). There was no correlation between the gender of the patient and the assessment or hospitalization decision of either male or female residents. Although this study has methodological limitations, it suggests that female emergency psychiatry residents are more likely to propose voluntary hospitalizations.

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“…5 Además, la decisión de admitir o referir a un paciente psiquiátrico dentro de una sala de urgencias tiene implicaciones médicas y económicas de alto alcance. 6 Así mismo se ha visto que cuando se implementan programas en los SUP consistentes en intervención en crisis en pacientes deprimidos, existe una disminución significativa en las hospitalizaciones psiquiátricas 7 y disminuyen los costos individuales, comunitarios y gubernamentales. 8 Además, los SUP son, en ocasiones, la única oportunidad para estimar la adherencia al tratamiento, la red de apoyo social y el pronóstico de los usuarios que demandan la consulta, 9,10 lo cual puede representar una oportunidad de brindar psicoeducación, afianzar el apego al tratamiento o validar una opinión médica previa.…”

Section: Introduccionunclassified

Indicadores de actividad durante cinco años en un servicio de urgencias de atención voluntaria de un hospital psiquiátrico mexicano

et al. 2014

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Introducción. Los Servicios de Urgencias Psiquiátricas (SUP) han reportado incremento en su demanda en los últimos anos. Se desconoce sobre los indicadores de actividad en SUP en hospitales psiquiátricos mexicanos. Se necesitan estudios que describan la actividad de estos servicios, especialmente los de atención voluntaria y sin procedimiento de valoración de la gravedad de las urgencias (triage) previo a la consulta. Objetivos. Describir y comparar los Indicadores de Actividad en un SUP de un hospital psiquiátrico de la Ciudad de México durante cinco años, en el que se ofreció atención voluntaria sin procedimiento de triage. Material y métodos. Se analizo una base de datos del SUP de todas las consultas otorgadas del 1o de enero de 2004 al 31 de diciembre de 2008. Se determinaron el total de consultas y las frecuencias relativas trimestral, semestral, anual y quinquenal desglosados por variables de utilización de servicio y diagnostico psiquiátrico según la CIE-10. Resultados. Se atendieron un total de n=41 058 consultas durante el quinquenio, encontrando incremento de 14.8% en la actividad global en el periodo. Se observo un incremento significativo de la proporción de pacientes sin adherencia a consulta externa así como mayor afluencia en el turno nocturno, mientras que la proporción de referencias y hospitalizaciones disminuyo más del 4%, sugiriendo aumento “en bola de nieve” de usuarios frecuentadores con condiciones no urgentes. No se encontraron cambios en la proporción de los diagnósticos psiquiátricos a lo largo del tiempo, pero hubo un aumento significativo del 9.69% en la actividad global en el primer semestre respecto del segundo. Discusión. La atención voluntaria sin procedimiento de triage tiende a generar mayor afluencia de pacientes frecuentadores con condiciones no urgentes, sobresaturando el servicio y desfavoreciendo las condiciones urgentes, especialmente durante el primer semestre del año.

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Economic impact of crisis intervention in emergency psychiatry: a naturalistic study

Abstract: These preliminary findings suggest that crisis intervention leads to a shift from hospitalization to outpatient psychotherapeutic management in emergency psychiatric services, which has a significant economic impact.

Cited by 20 publications

References 6 publications

A Systematic Review of Crisis Interventions Used in the Emergency Department

A Systematic Review of Crisis Interventions Used in the Emergency Department

Are Female Psychiatry Residents Better to Propose in Emergency a Voluntary Hospitalization?

Indicadores de actividad durante cinco años en un servicio de urgencias de atención voluntaria de un hospital psiquiátrico mexicano

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