title: Videoconferencing could reduce the number of mental health patients transferred from outlying facilities to a regional mental health unit.
abstract: OBJECTIVE
  To determine if the addition of a video link to the existing phone connection, enabling patients admitted for mental and behavioural disorders to be seen by a centrally located psychiatrist or mental health clinician, would change the probability of these patients being transferred to the central mental health unit.
  
  
  METHODS
  Data analysed were patients admitted (n=1,943) to a health services regional hospital with a primary diagnosis of mental and behavioural disorders (ICD10-AM code F00-F99) between January 2002 and December 2010. The probability of being transferred was modelled using multilevel random intercept logistic regression. The introduction of videoconferencing in January 2008 was examined by testing if the inclusion of a binary intervention variable was significant when added to the best fitting risk adjustment model.
  
  
  RESULTS
  After the introduction of videoconferencing the percentage of patients transferred fell from 66.8% (95%CI 64.0 to 69.5) to 59.6% (95%CI 56.1 to 63.1) (χ(2) =10.42, p=0.001). After adjusting for age, sex, clustering in hospitals and repeat visits the odds of transfer were 0.69 (95%CI 0.49 to 0.97) of previous. Aboriginality, being non-Australian, long-term linear trend, admitted on the weekends or after hours were not significant predictors of the probability of transfer.
  
  
  CONCLUSIONS
  The ability for the psychiatrist or senior mental health clinician to see mental health patients via videoconferencing was associated with a reduced probability of the patient being transferred. This satisfies the preference of patients to remain in their community and access mental health services.
authors.affiliation: Clinical Governance Unit, Murrumbidgee Local Health Network, New South, Australia. david.buckley@gsahs.health.nsw.gov.au
authors.forename: David
authors.initials: D
authors.lastname: Buckley
authors.forename: Susan
authors.initials: S
authors.lastname: Weisser
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia; D002648:Child; D005260:Female; D006297:Health Services Accessibility; D006739:Hospital Administration; D006801:Humans; D016015:Logistic Models; D008297:Male; D001523:Mental Disorders / Q000523:psychology / Q000628:therapy*; D008605:Mental Health Services / Q000458:organization & administration*; D008875:Middle Aged; D010360:Patient Transfer / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012423:Rural Health; D017678:Sex Distribution; D017216:Telemedicine / Q000458:organization & administration; D049269:Videoconferencing; D055815:Young Adult