Patient-controlled hospital admission for patients with severe mental disorders: study protocol for a nationwide prospective multicentre study.
BACKGROUND
Patient-controlled hospital admission for individuals with severe mental disorders is a novel approach in mental healthcare. Patients can admit themselves to a hospital unit for a short stay without being assessed by a psychiatrist or contacting the emergency department. Previous studies assessing the outcomes of patient-controlled hospital admission found trends towards reduction in the use of coercive measures and length of hospital stay; however, these studies have methodological shortcomings and small sample sizes. Larger studies are needed to estimate the effect of patient-controlled hospital admission on the use of coercion and of healthcare services.


METHODS
We aim to recruit at least 315 patients who are offered a contract for patient-controlled hospital admissions in eight different hospitals in Denmark. Patients will be followed-up for at least 1 year to compare the use of coercive measures and of healthcare services, the use of medications and suicidal behaviour. Descriptive statistics will be used to investigate hospitalisations, global assessment of functioning (GAF) and patient satisfaction with treatment. To minimise selection bias, we will match individuals using patient-controlled hospital admission and controls with a 1:5 ratio via a propensity score based on the following factors: sex, age group, primary diagnosis, substance abuse as secondary diagnosis, coercion, number of psychiatric bed days, psychiatric history, urbanity and suicidal behaviour. Additionally, a historical control study will be undertaken in which patients serve as their own control group prior to index date.


BACKGROUND
The study has been approved by The Danish Health and Medicines Authority (j.nr.: 3-3013-934/1/) and by The Danish Data Protection Agency (j.nr.: 2012-58-0004). The study was categorised as a register study by The Danish Health Research Ethics Committee and therefore no further approval was needed (j.nr.: H-2-2014-FSP70). Findings will be disseminated through scientific publications, presentations and in a PhD thesis.
Mental Health Centre Frederiksberg, Copenhagen University Hospital, Copenhagen, Denmark Mental Health Centre Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark.
Christoffer Torgaard
CT
Thomsen
Mental Health Centre Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark.
Michael Eriksen
ME
Benros
Mental Health Centre Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark Psychiatric Research Unit, Region Zealand, Slagelse, Denmark.
Lene Halling
LH
Hastrup
Department of Biostatistics, University of Copenhagen, Copenhagen, Denmark.
Per Kragh
PK
Andersen
Unit for Social and Community Psychiatry (World Health Organisation, Collaborating Centre for Mental Health Services Development), Queen Mary, University of London, London, UK.
Domenico
D
Giacco
Mental Health Centre Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark.
Merete
M
Nordentoft
EPIDEMIOLOGY; MENTAL HEALTH
Soc Psychiatry Psychiatr Epidemiol. 2014 Oct;49(10):1619-29
24737189
Scand J Public Health. 2011 Jul;39(7 Suppl):54-7
21775352
Psychiatr Q. 2011 Jun;82(2):163-75
20953707
Psychiatr Q. 2013 Sep;84(3):313-27
23076765
Scand J Public Health. 2011 Jul;39(7 Suppl):22-5
21775345
BMC Health Serv Res. 2010 Apr 06;10:89
20370928
Nord J Psychiatry. 2015;69(8):574-86
25832757
Perspect Psychiatr Care. 2012 Apr;48(2):83-94
21967236
Lancet Psychiatry. 2015 Jan;2(1):49-58
26359612
Tidsskr Nor Laegeforen. 2008 Jan 3;128(1):32-5
18183054
BMJ. 2013 May 14;346:f2614
23674136
Clin Pract Epidemiol Ment Health. 2013 Jul 12;9:110-9
23986786
Aust N Z J Psychiatry. 1999 Jun;33(3):429-32
10442801
Soc Psychiatry Psychiatr Epidemiol. 2012 Aug;47(8):1251-61
21947476
Soc Psychiatry Psychiatr Epidemiol. 2010 Sep;45(9):889-97
19727530
Perspect Psychiatr Care. 2014 Jan;50(1):65-75
24387616
Int J Ment Health Syst. 2016 Feb 25;10:11
26918028
Scand J Public Health. 2011 Jul;39(7 Suppl):30-3
21775347
Eval Program Plann. 1982;5(3):233-7
10259963
Scand J Public Health. 2011 Jul;39(7 Suppl):38-41
21775349
Br J Psychiatry. 2007 Oct;191:298-303
17906239