[Can case-mix explain differences in involuntary admissions?].
BACKGROUND
The proportion of patients admitted involuntarily varies considerably among Norwegian psychiatric hospitals. We tested the hypothesis that these variations are the result of differences in case-mix.


METHODS
The observed differences in involuntary admissions to Norwegian psychiatric hospitals were compared to those expected on the basis of their case-mix, as predicted by our multivariate model (multinomial logistic regression). The material was based on a cross-sectional registration of hospitalized patients in Norwegian psychiatric hospitals as of 1 November 1999. Thirty-two hospitals (all Norwegian hospitals that take involuntary admissions) supplied data on a total of 1,500 patients.


RESULTS
The analysis shows that a large amount of the observed variation in involuntary admissions is related to differences in case-mix. However, for patients involuntarily admitted for observation, the case-mix was found to have less explanatory effect. Age, sex, previous admissions and diagnoses were used to operationalize hospital case-mix.


CONCLUSIONS
The analysis also indicated that other explanatory factors should be explored, such as differences in admission threshold and in medical decision in explaining variation in involuntary psychiatric admissions.
Bjørngaard
J H
JH
SINTEF Unimed Helsetjenesteforskning 7465 Trondheim. johan.h.bjorngaard@unimed.sintef.no
Heggestad
T
T
D000293:Adolescent; D000328:Adult; D003134:Commitment of Persons with Psychiatric Disorders / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D003657:Decision Making; D003953:Diagnosis-Related Groups; D006801:Humans; D001523:Mental Disorders / Q000145:classification / Q000175:diagnosis*; D008875:Middle Aged; D015233:Models, Statistical; D015999:Multivariate Analysis; D009664:Norway; D010359:Patient Readmission / Q000706:statistics & numerical data