High utilizers of psychiatric emergency services.
ABSTRACT The purpose of this study was to examine the sociodemographic and clinical characteristics of high utilizers of psychiatric emergency services.
Data were collected over four years for 761 patients who were identified as high utilizers according to three definitions (two standard deviations above the mean number of visits to an urban psychiatric emergency service, six visits in a year, and four visits in a quarter) and for 1,585 nonfrequent utilizers (control group). Univariate analysis of variance and logistic regression models were used to determine group differences.
Two distinct groups of high utilizers emerged: high utilizers by quarter and high utilizers by standard deviation. Compared with the control group, the high utilizers were more likely to be homeless, to have developmental delays, to be enrolled in a mental health plan, to have a history of voluntary and involuntary hospitalizations, to be uncooperative, to have personality disorders, to have unreliable social support, and to have a lifetime history of incarceration and detoxification. Compared with the high utilizers by quarter, the high utilizers by standard deviation had more visits and were more likely to have a history of incarceration and psychiatric hospitalization, more likely to be enrolled in mental health plan, and less likely to be homeless.
High utilizers make up a small percentage of individuals who seek care in psychiatric emergency services and disproportionately use resources. It may be helpful to use two definitions of high utilizer to identify patients at different phases of their illness and to guide clinical interventions and mental health policies.
- SourceAvailable from: Luis Jiménez-Trevino
Conference Paper: Frequent vs. infrequent visitors to a Psychiatric Emergency Service[Show abstract] [Hide abstract]
ABSTRACT: A subgroup of patients makes frequent use of hospital emergency departments (EDs), thereby accounting for a substantial portion of the total number of visits to these facilities. This phenomenon has been reported from many countries, irrespective of the prevailing health care system (1)Frequent visitors are estimated to account for as many as one-third of all visits to psychiatric emergency services (2). This shift in where psychiatric patients are obtaining care is a consequence of deinstitutionalization, increasingly limited outpatient resources, and an increase in substance abuse (3)APA 163rd ANNUAL MEETING, New Orleans, USA; 05/2010
- [Show abstract] [Hide abstract]
ABSTRACT: People experiencing homelessness and mental illness face multiple barriers to care. The goal of this study was to examine the association between health service use and indicators of need among individuals experiencing homelessness and mental illness in Vancouver, Canada. We hypothesized that those with more severe mental illness would access greater levels of primary and specialist health services than those with less severe mental illness.BMC Health Services Research 09/2014; 14(1):404. · 1.66 Impact Factor
- [Show abstract] [Hide abstract]
ABSTRACT: When a psychiatric patient in the emergency department requires inpatient admission, but no bed is available, they may become a "boarder." The psychiatric emergency service (PES) has been suggested as one means to reduce psychiatric boarding, but the frequency and characteristics of adult PES boarders have not been described.The western journal of emergency medicine 09/2014; 15(6):669-74.