TY - JOUR
T1 - Specialty Psychiatric Services in US Emergency Departments and General Hospitals
T2 - Results From a Nationwide Survey
AU - Ellison, Ashley G.
AU - Jansen, Luc A.W.
AU - Nguyen, Francis
AU - Martina, Andrew
AU - Spencer, Jordan
AU - Wierdsma, André I.
AU - Kathol, Roger G.
AU - van Schijndel, Maarten A.
N1 - Publisher Copyright: © 2021 The Authors
PY - 2022/5
Y1 - 2022/5
N2 - Objective: To explore the handling of psychiatric patients in medical hospitals and emergency departments (EDs) as well as hospital characteristics associated with the availability of psychiatric services in these settings. Methods: From October 1, 2017, to April 1, 2018, a telephone survey regarding the presence and nature of psychiatric services was attempted among all US registered Medicare hospitals. Results: Of the included 4812 US hospitals, 2394 (50%) were surveyed. Of these hospitals, 1108 (46%) have some psychiatric services available, either in medical EDs or through psychiatric consultation on general medical inpatient wards. If medical ED patients with active psychiatric issues need admission, 59% of hospitals transfer the patient to a different hospital and 28% admit the patient to a medical ward. Exploration by logistic regression analysis of the association of selected variables and available psychiatric expertise suggested that larger hospitals, nonprofit services, or hospitals in urban settings were more likely to have psychiatrists on staff or available for consultation. Conclusion: Despite the growing number of psychiatric patients seeking help in medical EDs and general hospitals, more than 50% of the EDs and general hospitals lack psychiatric services. These results suggest that accessibility to psychiatric care in medical settings requires improvement.
AB - Objective: To explore the handling of psychiatric patients in medical hospitals and emergency departments (EDs) as well as hospital characteristics associated with the availability of psychiatric services in these settings. Methods: From October 1, 2017, to April 1, 2018, a telephone survey regarding the presence and nature of psychiatric services was attempted among all US registered Medicare hospitals. Results: Of the included 4812 US hospitals, 2394 (50%) were surveyed. Of these hospitals, 1108 (46%) have some psychiatric services available, either in medical EDs or through psychiatric consultation on general medical inpatient wards. If medical ED patients with active psychiatric issues need admission, 59% of hospitals transfer the patient to a different hospital and 28% admit the patient to a medical ward. Exploration by logistic regression analysis of the association of selected variables and available psychiatric expertise suggested that larger hospitals, nonprofit services, or hospitals in urban settings were more likely to have psychiatrists on staff or available for consultation. Conclusion: Despite the growing number of psychiatric patients seeking help in medical EDs and general hospitals, more than 50% of the EDs and general hospitals lack psychiatric services. These results suggest that accessibility to psychiatric care in medical settings requires improvement.
UR - http://www.scopus.com/inward/record.url?scp=85127926386&partnerID=8YFLogxK
U2 - 10.1016/j.mayocp.2021.10.025
DO - 10.1016/j.mayocp.2021.10.025
M3 - Article
C2 - 35410751
AN - SCOPUS:85127926386
SN - 0025-6196
VL - 97
SP - 862
EP - 870
JO - Mayo Clinic Proceedings
JF - Mayo Clinic Proceedings
IS - 5
ER -