Tzu-Yu Liu1, Chi-Shin Wu2, Ming H Hsieh3. 1. Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan. 2. Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan. Electronic address: chishinwu@ntu.edu.tw. 3. Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan. Electronic address: hsieh.mingh@gmail.com.
Abstract
OBJECTIVE: This study aimed to investigate whether weekend admissions to psychiatric wards in Taiwan were associated with different patient characteristics or worse clinical outcomes. METHOD: Patients with acute psychiatric admissions between 1996 and 2012 were included based on the National Health Insurance Research Database. The patients' baseline characteristics were recorded. The study outcomes included inpatient mortality, length of stay, and readmission within 30 days. Multivariable linear regression and multivariable logistic regression with adjustment for age, sex, diagnosis, and compulsory hospitalization status were performed. RESULTS: Among 661,709 acute psychiatric admissions, there were 82,450 weekend admissions. The patients with weekend admissions tended to be younger and the proportion of patients with schizophrenia, bipolar affective disorder, substance use disorder, and compulsory hospitalization were higher. Weekend admissions were associated with a shorter length of stay (30.3 days vs. 33.3 days, p < 0.001), lower inpatient morality rate (0.07% vs. 0.11%, p = 0.007), but higher readmission rate (26.8% vs. 25.3%, p < 0.001). CONCLUSION: The impact of weekend admission on clinical outcomes was relatively small compared to the differences in demographic and clinical characteristics. Despite the small influence of weekend admission, evaluation of the quality of care provided at weekends requires further attention and research to improve mental health care.
OBJECTIVE: This study aimed to investigate whether weekend admissions to psychiatric wards in Taiwan were associated with different patient characteristics or worse clinical outcomes. METHOD:Patients with acute psychiatric admissions between 1996 and 2012 were included based on the National Health Insurance Research Database. The patients' baseline characteristics were recorded. The study outcomes included inpatient mortality, length of stay, and readmission within 30 days. Multivariable linear regression and multivariable logistic regression with adjustment for age, sex, diagnosis, and compulsory hospitalization status were performed. RESULTS: Among 661,709 acute psychiatric admissions, there were 82,450 weekend admissions. The patients with weekend admissions tended to be younger and the proportion of patients with schizophrenia, bipolar affective disorder, substance use disorder, and compulsory hospitalization were higher. Weekend admissions were associated with a shorter length of stay (30.3 days vs. 33.3 days, p < 0.001), lower inpatient morality rate (0.07% vs. 0.11%, p = 0.007), but higher readmission rate (26.8% vs. 25.3%, p < 0.001). CONCLUSION: The impact of weekend admission on clinical outcomes was relatively small compared to the differences in demographic and clinical characteristics. Despite the small influence of weekend admission, evaluation of the quality of care provided at weekends requires further attention and research to improve mental health care.
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