Factors associated with emergency department use for mental health reasons among low, moderate and high users.
|Title||Factors associated with emergency department use for mental health reasons among low, moderate and high users.|
|Publication Type||Journal Article|
|Year of Publication||2019|
|Authors||MJ Fleury, Rochette L, Grenier G, Huỳnh C, Vasiliadis H-M, Pelletier É, Lesage A|
|Journal||Gen Hosp Psychiatry|
|Date Published||2019 Sep - Oct|
OBJECTIVES: This study identified factors associated with frequency of emergency department (ED) use for mental health (MH) reasons in Quebec during 2015-2016.METHODS: Participants (n = 115,066) were categorized as: 1) low (1 visit/year; 76%); 2) moderate (2 visits/year; 14%); and 3) high (3+ visits/year; 10%) ED users. Independent variables included predisposing, enabling and needs factors based on the Andersen Behavioral Model. Variables significantly associated with frequency of ED use were entered into a multinomial logistic regression.RESULTS: Patients with mental illness (MI), especially substance-related disorders (SRD) and schizophrenia spectrum disorders; bipolar, depressive, anxiety or personality disorders; and those with severe chronic physical illness (needs factors) were more likely to use ED for MH reasons, as were male participants 18-64 years old, and those living in metropolitan areas with high social or material deprivation (predisposing factors). Regarding enabling factors, consultations with outpatient psychiatrists and not seeing a general practitioner (GP) in the year prior to ED visit were associated with high ED use.CONCLUSION: The severity of MI/SRD contributed most to frequent ED use, while social and material deprivation in metropolitan areas, and intensity of medical care also influenced ED use for MH reasons.
|Alternate Journal||Gen Hosp Psychiatry|