title: Acute hospital service utilization by inpatients in psychiatric hospitals.
abstract: OBJECTIVE
  Standardized mortality ratios are twice the population average in the year following a mental health admission, yet there is a relative paucity of research on uptake of general medical care in psychiatric inpatients.
  
  
  METHODS
  A retrospective database analysis was performed to ascertain the frequency of acute medical care usage by psychiatric inpatients. Data were gathered through a static linkage between anonymized clinical records in a large UK mental health provider and the national hospital activity database (Hospital Episode Statistics) over 1year from 2010 to 2011.
  
  
  RESULTS
  Over the year, 10.4% of the 8023 psychiatric admission episodes included at least one night in a general hospital during that psychiatric inpatient stay, while 12.0% of psychiatry admission episodes entailed an emergency department (ED) visit. Over the course of the full year, of the 4674 people admitted to the mental health provider at least once, 16.0% were admitted to a general hospital while registered as a mental health inpatient and 18.0% were seen in the ED. Patients were simultaneously registered as occupying beds in both general and psychiatric hospitals for a total of 5163 bed days at a cost of £2.4 million over the year.
  
  
  CONCLUSIONS
  This large population-based linkage study indicates a high rate of general hospital utilization by psychiatric inpatients in an independent mental health provider. The need for combined, flexible and practical approaches to the medical care of psychiatric inpatients is highlighted to reduce unplanned care and provide treatment in the site best suited to the patient's needs.
authors: Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London and National Psychosis Service, South London and Maudsley NHS Foundation Trust, London, United Kingdom. Electronic address: john.lally@kcl.ac.uk.
authors: John
authors: J
authors: Lally
authors: Coventry and Warwickshire Partnership NHS Trust, Coventry, United Kingdom.
authors: Yim Lun
authors: YL
authors: Wong
authors: BRC Case Register, South London and Maudsley NHS Foundation Trust, London, United Kingdom.
authors: Hitesh
authors: H
authors: Shetty
authors: Centre for the Economics of Mental and Physical Health and Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.
authors: Anita
authors: A
authors: Patel
authors: Department of Trauma, Emergency and Acute Medicine, King's College Hospital, London, United Kingdom.
authors: Vivek
authors: V
authors: Srivastava
authors: Institute of Psychiatry, King's College London and South London and Maudsley NHS Foundation Trust, London, United Kingdom.
authors: Matthew T M
authors: MT
authors: Broadbent
authors: National Psychosis Service, South London and Maudsley NHS Foundation Trust and the Biomedical Research Centre, BRC Nucleus, Maudsley Hospital, South London, London, United Kingdom; Maudsley NHS Foundation Trust, London, United Kingdom; Institute of Psychiatry, Psychology and Neuroscience, King's College, London, United Kingdom.
authors: Fiona
authors: F
authors: Gaughran
mesh_terms: D016208:Databases, Factual; D004636:Emergency Service, Hospital / Q000191:economics / Q000706:statistics & numerical data*; D005260:Female; D006760:Hospitalization / Q000639:trends; D006778:Hospitals, Psychiatric; D006801:Humans; D008297:Male; D028642:Persons with Psychiatric Disorders; D012189:Retrospective Studies; D006113:United Kingdom
keywords: Hospital admission; Medical comorbidity; Physical Health; Schizophrenia; Severe Mental Illness