Repeated psychiatric referrals to Belgian emergency departments: a survival analysis of the time interval between first and second episodes

Spooren, Daniël; Bacquer, Dirk De; Heeringen, Kees van; Jannes, Constantin

doi:10.1097/00063110-199706000-00002

Cited by 23 publications

(18 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Almost 44 percent of the patients in the study were referred to the psychiatric emergency department within 60 days of hospital discharge, a proportion similar to those reported in previous studies (6,15). We were, however, somewhat surprised to find that 55 percent of the patients with a short community stay were rehospitalized after visiting the psychiatric emergency department.…”

Section: Discussionsupporting

confidence: 85%

See 1 more Smart Citation

Effects of Patient and Health-System Characteristics on Community Tenure of Discharged Psychiatric Inpatients

Bruffærts¹,

Sabbé²,

Demyttenaere³

2004

View full text Add to dashboard Cite

6 68 85 5 O ver the past two decades, the organization and provision of mental health care have changed dramatically. The deinstitutionalization of mental health services has resulted in shorter stays in psychiatric hospitals and in larger numbers of psychiatric patients living in the community (1). Many communities have too few resources to help these patients (2). The number of psychiatric referrals to hospital emergency departments has increased, partly because of the general lack of linkage between institutional and community services (3). This trend has been observed both in the United States and in Europe (4).Previous research has provided consistent evidence that persons with previous use of psychiatric services are among the most frequent users of psychiatric emergency departments (5-10). Moreover, patients who are readmitted to inpatient psychiatric care are often found to have been recently discharged from a psychiatric hospitalization. In previous studies, 24 percent of 262 patients (11) and 38 percent of 128 patients (12) with a recent hospital discharge were readmitted within three to six months. In a study of state hospital patients in Massachusetts, Fisher and colleagues (13) found a 50 percent readmission rate within four years of discharge among 5,610 patients. Early hospital readmission has been related to the presence of mental illnesses with poor prognoses (13-15), to poor quality of patients' social networks, and to patients' difficulties with hygiene at discharge (16).Early readmissions, however, may also reflect the quality of postdischarge treatment and care. Some unplanned psychiatric referrals could be explained by the unexpected and acute progression of the patient's mental illness, but the rest may result because the mentally ill person has been discharged from the hospital too soon or because follow-up in the community is ineffective.Lower readmission rates have been associated with the existence of follow-up services. For example, McIntosh and Worley (17) implemented telephone follow-up and aftercare groups for patients who were discharged from a psychiatric hospitalization. Fifteen months after the implementation of these services, these authors found a readmission rate of

show abstract

Section: Discussionsupporting

confidence: 85%

“…Previous research has provided consistent evidence that persons with previous use of psychiatric services are among the most frequent users of psychiatric emergency departments (5)(6)(7)(8)(9)(10). Moreover, patients who are readmitted to inpatient psychiatric care are often found to have been recently discharged from a psychiatric hospitalization.…”

mentioning

confidence: 88%

Effects of Patient and Health-System Characteristics on Community Tenure of Discharged Psychiatric Inpatients

Bruffærts¹,

Sabbé²,

Demyttenaere³

2004

View full text Add to dashboard Cite

show abstract

“…Frequent specialized service users are generally male (Sullivan et al 1993), young or middleaged (Spooren et al 1997), and live alone (Saaranto et al 1998). In addition, they lack social support (Ledoux and Minner 2006;Pasic et al 2005) and are often unemployed (Sullivan et al 1993) and homeless (Pasic et al 2005).…”

Section: Introductionmentioning

confidence: 99%

“…The main reported diagnoses are schizophrenia and other psychotic disorders (Hansen and Elliot 1993;Saaranto et al 1998;Sullivan et al 1993) and personality disorders (Ellison et al 1989;Pasic et al 2005;Sullivan et al 1993). They often have concurrent problems of substance abuse (Ellison et al 1989;Hansen and Elliot 1993;Spooren et al 1997) and chronic illness (Ellison et al 1989;Kent et al 1995). Frequent users often present a complex mixture of non-active psychosis or disorganized residual schizophrenia, associated with a less severe or structured psychopathology (Ledoux and Minner 2006).…”

Section: Introductionmentioning

confidence: 99%

“…Frequent users often present a complex mixture of non-active psychosis or disorganized residual schizophrenia, associated with a less severe or structured psychopathology (Ledoux and Minner 2006). The number of voluntary or involuntary hospitalizations (Ellison et al 1989;Pasic et al 2005;Spooren et al 1997), non-compliance to medication (Green 1988;Haywood et al 1995), self-referral (Ellison et al 1989;Ledoux and Minner 2006;Spooren et al 1997) and inadequate access to aftercare (Green 1988;Korkeila et al 1998) are the main service-use variables associated with frequent readmission to hospital or psychiatric emergency rooms.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Mental Health Service Utilization Among Patients with Severe Mental Disorders

Fleury

Grenier

Bamvita

et al. 2010

Community Ment Health J

View full text Add to dashboard Cite

In light of healthcare reforms, the study aims to assess variables associated with mental healthcare service utilization in general and in both primary and specialized care by patients with severe mental disorders (SMD, mainly schizophrenia). The study is based on a sample of 140 patients with SMD from five regions in Quebec (Canada). Variables were organized in accordance with Andersen's conceptual model into four factors: predisposing, enabling, needs, and service utilization. Secondary analyses were also conducted comparing patients who were hospitalized or used emergency rooms (H.ER-Group) with patients who did not use such services (WH.ER-Group). Accessibility of services, continuity of care, and having a case manager appear to be core variables that enable service utilization. Compared with the WH.ER-Group, the H.ER-Group used twice as many services. The study highlights the importance of developing a gamut of coordinated services, easily accessible in local networks, including case managers, family physicians, and shared-care development.

show abstract

Frequent visitors to psychiatric emergency services: Staff attitudes and temporal patterns

Arfken

Zeman

Yeager

et al. 2002

The Journal of Behavioral Health Services & Research

View full text Add to dashboard Cite

Providing quality psychiatric emergency services is becoming more difficult as utilization rates soar, especially by individuals who are frequent visitors. To address this issue, a staff survey and analysis of admission patterns were conducted. Staff were more likely to believe that frequent visitors sought care because they had difficulty accessing alternative services, had basic needs unmet, were substance abusers, wanted inpatient admission, and were noncompliant with treatment plans. The 1999 temporal admission pattern documented that frequent visitors' admissions were higher during the first week of the month and inclement weather. Surprisingly, the infrequent visitors' admissions also were higher during the first week of the month. Together, these findings suggest that, in this urban location, frequent visitors are disadvantaged individuals lacking support and alternative treatment settings who use psychiatric emergency services to meet basic needs.

show abstract

Repeated psychiatric referrals to Belgian emergency departments: a survival analysis of the time interval between first and second episodes

Cited by 23 publications

References 0 publications

Effects of Patient and Health-System Characteristics on Community Tenure of Discharged Psychiatric Inpatients

Effects of Patient and Health-System Characteristics on Community Tenure of Discharged Psychiatric Inpatients

Mental Health Service Utilization Among Patients with Severe Mental Disorders

Frequent visitors to psychiatric emergency services: Staff attitudes and temporal patterns

Contact Info

Product

Resources

About