Factors associated with admission to hospital following emergency psychiatric assessment.
Psychiatric emergencies account for a large proportion of total referrals and admissions yet there has been little research in the United Kingdom into factors associated with admission after emergency psychiatric assessment. We conducted a one year prospective study of all emergency referrals from Borders Region in Scotland. Four hundred and eighty-seven emergencies were assessed and 153 (31%) of these were admitted. The main predictors of admission after stepwise logistic regression analysis were: risk to self (odds ratio 1.76 for each point increment on a five point scale, 95% confidence intervals 1.43 to 2.15), current contact with the psychiatric services (2.46; 1.52, 3.98) and psychotic diagnosis (2.38; 1.47, 3.87). Compared to subjects assessed at home, those assessed at the psychiatric hospital were more likely to be admitted (3.73; 1.99, 6.99) and self-referrals were less likely to be admitted than General Practitioner referrals (0.22; 0.08, 0.55). Our results suggest that future studies of emergency services should investigate and control for both clinical and service variables.
Taylor
J
J
Dingleton Hospital, Melrose.
Lawrie
S
S
Geddes
J
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D003710:Demography; D004630:Emergencies; D004637:Emergency Services, Psychiatric / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis*; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D010343:Patient Admission; D011446:Prospective Studies; D012606:Scotland; D012959:Socioeconomic Factors