Impact of Co-occurring Mental Disorders and Chronic Physical Illnesses on Frequency of Emergency Department Use and Hospitalization for Mental Health Reasons

Background: Patients with mental disorders (MD) are at high risk for a wide range of chronic physical illnesses (CPI), often resulting in greater use of acute care services. This study estimated risk of emergency department (ED) use and hospitalization for mental health (MH) reasons among 678 patien...

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Autores principales:	Lia Gentil, Guy Grenier, Xiangfei Meng, Marie-Josée Fleury
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	co-occurring mental disorders chronic physical illnesses emergency department (ED) use hospitalization clinical variables sociodemographic variables Psychiatry RC435-571
Acceso en línea:	https://doaj.org/article/92dcd9ef773b498b81966578eb976ef8
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spelling	oai:doaj.org-article:92dcd9ef773b498b81966578eb976ef82021-11-22T04:43:15ZImpact of Co-occurring Mental Disorders and Chronic Physical Illnesses on Frequency of Emergency Department Use and Hospitalization for Mental Health Reasons1664-064010.3389/fpsyt.2021.735005https://doaj.org/article/92dcd9ef773b498b81966578eb976ef82021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fpsyt.2021.735005/fullhttps://doaj.org/toc/1664-0640Background: Patients with mental disorders (MD) are at high risk for a wide range of chronic physical illnesses (CPI), often resulting in greater use of acute care services. This study estimated risk of emergency department (ED) use and hospitalization for mental health (MH) reasons among 678 patients with MD and CPI compared to 1,999 patients with MD only.Methods: Patients visiting one of six Quebec (Canada) ED for MH reasons and at onset of a MD in 2014–15 (index year) were included. Negative binomial models comparing the two groups estimated risk of ED use and hospitalization at 12-month follow-up to index ED visit, controlling for clinical, sociodemographic, and service use variables.Results: Patients with MD, more severe overall clinical conditions and those who received more intensive specialized MH care had higher risks of frequent ED use and hospitalization. Continuity of medical care protected against both ED use and hospitalization, while general practitioner (GP) consultations protected against hospitalization only. Patients aged 65+ had lower risk of ED use, whereas risk of hospitalization was higher for the 45–64- vs. 12–24-year age groups, and for men vs. women.Conclusion: Strategies including assertive community treatment, intensive case management, integrated co-occurring treatment, home treatment, and shared care may improve adequacy of care for patients with MD-CPI, as well as those with MD only whose clinical profiles were severe. Prevention and outreach strategies may also be promoted, especially among men and older age groups.Lia GentilLia GentilGuy GrenierXiangfei MengXiangfei MengMarie-Josée FleuryMarie-Josée FleuryFrontiers Media S.A.articleco-occurring mental disorderschronic physical illnessesemergency department (ED) usehospitalizationclinical variablessociodemographic variablesPsychiatryRC435-571ENFrontiers in Psychiatry, Vol 12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	co-occurring mental disorders chronic physical illnesses emergency department (ED) use hospitalization clinical variables sociodemographic variables Psychiatry RC435-571
spellingShingle	co-occurring mental disorders chronic physical illnesses emergency department (ED) use hospitalization clinical variables sociodemographic variables Psychiatry RC435-571 Lia Gentil Lia Gentil Guy Grenier Xiangfei Meng Xiangfei Meng Marie-Josée Fleury Marie-Josée Fleury Impact of Co-occurring Mental Disorders and Chronic Physical Illnesses on Frequency of Emergency Department Use and Hospitalization for Mental Health Reasons
description	Background: Patients with mental disorders (MD) are at high risk for a wide range of chronic physical illnesses (CPI), often resulting in greater use of acute care services. This study estimated risk of emergency department (ED) use and hospitalization for mental health (MH) reasons among 678 patients with MD and CPI compared to 1,999 patients with MD only.Methods: Patients visiting one of six Quebec (Canada) ED for MH reasons and at onset of a MD in 2014–15 (index year) were included. Negative binomial models comparing the two groups estimated risk of ED use and hospitalization at 12-month follow-up to index ED visit, controlling for clinical, sociodemographic, and service use variables.Results: Patients with MD, more severe overall clinical conditions and those who received more intensive specialized MH care had higher risks of frequent ED use and hospitalization. Continuity of medical care protected against both ED use and hospitalization, while general practitioner (GP) consultations protected against hospitalization only. Patients aged 65+ had lower risk of ED use, whereas risk of hospitalization was higher for the 45–64- vs. 12–24-year age groups, and for men vs. women.Conclusion: Strategies including assertive community treatment, intensive case management, integrated co-occurring treatment, home treatment, and shared care may improve adequacy of care for patients with MD-CPI, as well as those with MD only whose clinical profiles were severe. Prevention and outreach strategies may also be promoted, especially among men and older age groups.
format	article
author	Lia Gentil Lia Gentil Guy Grenier Xiangfei Meng Xiangfei Meng Marie-Josée Fleury Marie-Josée Fleury
author_facet	Lia Gentil Lia Gentil Guy Grenier Xiangfei Meng Xiangfei Meng Marie-Josée Fleury Marie-Josée Fleury
author_sort	Lia Gentil
title	Impact of Co-occurring Mental Disorders and Chronic Physical Illnesses on Frequency of Emergency Department Use and Hospitalization for Mental Health Reasons
title_short	Impact of Co-occurring Mental Disorders and Chronic Physical Illnesses on Frequency of Emergency Department Use and Hospitalization for Mental Health Reasons
title_full	Impact of Co-occurring Mental Disorders and Chronic Physical Illnesses on Frequency of Emergency Department Use and Hospitalization for Mental Health Reasons
title_fullStr	Impact of Co-occurring Mental Disorders and Chronic Physical Illnesses on Frequency of Emergency Department Use and Hospitalization for Mental Health Reasons
title_full_unstemmed	Impact of Co-occurring Mental Disorders and Chronic Physical Illnesses on Frequency of Emergency Department Use and Hospitalization for Mental Health Reasons
title_sort	impact of co-occurring mental disorders and chronic physical illnesses on frequency of emergency department use and hospitalization for mental health reasons
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/92dcd9ef773b498b81966578eb976ef8
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Impact of Co-occurring Mental Disorders and Chronic Physical Illnesses on Frequency of Emergency Department Use and Hospitalization for Mental Health Reasons

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