René Klinkby Støving1,2,3,4, Pia Veldt Larsen3, Laura Al-Dakhiel Winkler1,3, Niels Bilenberg3, Michael Ejnar Røder5, Hans-Christoph Steinhausen3,6,7,8. 1. Center for Eating Disorders, Odense University Hospital, Odense, Denmark. 2. Research Unit for Medical Endocrinology, Odense University Hospital, Odense, Denmark. 3. Department of Child and Adolescent Mental Health Odense, Mental Health Services in the Region of Southern Denmark, Odense, Denmark. 4. Open Patient data Explorative Network (OPEN), Clinical Institute, University of Southern Denmark, Odense, Denmark. 5. Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark. 6. Denmark Child and Adolescent Mental Health Centre, Capital Region Psychiatry, Copenhagen, Denmark. 7. Department of Child and Adolescent Psychiatry, Psychiatric University Hospital of Zurich, Zurich, Switzerland. 8. Clinical Psychology and Epidemiology, Institute of Psychology, University of Basel, Basel, Switzerland.
Abstract
BACKGROUND: Treating patients with anorexia nervosa (AN) remains a major challenge. The choice between an inpatient or an outpatient care setting is an essential issue for the patients and for their relatives with major health economic implications. However, health services-related studies are lacking. The present study was a descriptive exploration of time-trends in treatment modes of patients with free and equal access to health services. METHODS: The study was based on a nationwide cohort of patients diagnosed for the first time with AN, each followed for 5 years in the registers covering the years 1994-2018. The per patient number of hospital admissions, cumulated number of days of hospitalization and number of outpatient visits during the first 5 years after initial diagnosis were considered. RESULTS: The cohort of patients with AN with at least 5 years of follow-up amounted to N = 7,505. A clear trend was observed in the per patient five-year cumulated number of inpatient days, decreasing by 6% per year after adjustment for age at diagnosis, parental mental diagnosis, and family income. The five-year number of hospital admissions after initial diagnosis decreased by 2% per year, while no trend was observed for outpatient visits. CONCLUSIONS: The per patient number of hospitalizations and cumulated days of hospitalization during 5 years after diagnosis were reduced for patients initially diagnosed with AN while there was no change in the number of outpatient visits. The factors contributing to these changes of treatment modes over time are in need of further study.
BACKGROUND: Treating patients with anorexia nervosa (AN) remains a major challenge. The choice between an inpatient or an outpatient care setting is an essential issue for the patients and for their relatives with major health economic implications. However, health services-related studies are lacking. The present study was a descriptive exploration of time-trends in treatment modes of patients with free and equal access to health services. METHODS: The study was based on a nationwide cohort of patients diagnosed for the first time with AN, each followed for 5 years in the registers covering the years 1994-2018. The per patient number of hospital admissions, cumulated number of days of hospitalization and number of outpatient visits during the first 5 years after initial diagnosis were considered. RESULTS: The cohort of patients with AN with at least 5 years of follow-up amounted to N = 7,505. A clear trend was observed in the per patient five-year cumulated number of inpatient days, decreasing by 6% per year after adjustment for age at diagnosis, parental mental diagnosis, and family income. The five-year number of hospital admissions after initial diagnosis decreased by 2% per year, while no trend was observed for outpatient visits. CONCLUSIONS: The per patient number of hospitalizations and cumulated days of hospitalization during 5 years after diagnosis were reduced for patients initially diagnosed with AN while there was no change in the number of outpatient visits. The factors contributing to these changes of treatment modes over time are in need of further study.
Authors: Elisabet Wentz; I Carina Gillberg; Henrik Anckarsäter; Christopher Gillberg; Maria Råstam Journal: Br J Psychiatry Date: 2009-02 Impact factor: 9.319
Authors: S Madden; J Miskovic-Wheatley; A Wallis; M Kohn; J Lock; D Le Grange; B Jo; S Clarke; P Rhodes; P Hay; S Touyz Journal: Psychol Med Date: 2014-07-14 Impact factor: 7.723
Authors: Katrin Elisabeth Giel; Peter Martus; Kathrin Schag; Stephan Herpertz; Tobias Hofmann; Antonius Schneider; Martin Teufel; Ulrich Voderholzer; Jörn von Wietersheim; Beate Wild; Almut Zeeck; Wolfgang Bethge; Ulrike Schmidt; Stephan Zipfel; Florian Junne Journal: J Eat Disord Date: 2021-05-19