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Author Warren, Mark B. ♦ Campbell, Ronna L. ♦ Nestler, David M. ♦ Pasupathy, Kalyan S. ♦ Lohse, Christine M. ♦ Koch, Karen A. ♦ Schlechtinger, Eduard ♦ Schmidt, Scott T. ♦ Melin, Gabrielle J.
Source World Health Organization (WHO)-Global Index Medicus
Content type Text
Publisher Elsevier
File Format HTM / HTML
Language English
Difficulty Level Medium
Subject Domain (in DDC) Philosophy & psychology ♦ Psychology ♦ Social sciences ♦ Social problems & services; associations ♦ Social welfare problems & services ♦ Natural sciences & mathematics ♦ Life sciences; biology ♦ Physiology & related subjects ♦ Natural history of organisms ♦ Technology ♦ Medicine & health ♦ Human physiology ♦ Incidence & prevention of disease ♦ Pharmacology and therapeutics ♦ Diseases ♦ Manufacture for specific uses ♦ Precision instruments & other devices
Subject Domain (in MeSH) Eukaryota ♦ Organisms ♦ Therapeutics ♦ Investigative Techniques ♦ Analytical, Diagnostic and Therapeutic Techniques and Equipment ♦ Mental Disorders ♦ Psychiatry and Psychology ♦ Physical Phenomena ♦ Biological Sciences ♦ Persons ♦ Persons ♦ Health Care Facilities, Manpower, and Services ♦ Health Care
Subject Keyword Discipline Emergency ♦ Discipline Medicine ♦ Emergency Service, Hospital ♦ Statistics & Numerical Data ♦ Length Of Stay ♦ Mental Disorders ♦ Diagnosis ♦ Adolescent ♦ Adult ♦ Aged ♦ Aged, 80 And Over ♦ Child ♦ Female ♦ Humans ♦ Male ♦ Middle Aged ♦ Patient Transfer ♦ Predictive Value Of Tests ♦ Restraint, Physical ♦ Seasons ♦ Journal Article ♦ Observational Study
Abstract BACKGROUND: We aimed to evaluate factors associated with prolonged emergency department (ED) length of stay (LOS) among psychiatric patients and to develop a multivariable predictive model to guide future interventions to reduce ED LOS. METHODS: Electronic health records of ED patients receiving a psychiatric consultation and providing research authorization were reviewed from September 14, 2010, through September 13, 2013, at an academic hospital with approximately 73000 visits annually. Prolonged LOS was defined as ≥8 hours. RESULTS: We identified 9247 visits among 6335 patients; median LOS was 4.1 hours, with 1424 visits (15%) with prolonged LOS. In the multivariable model, characteristics associated with an increased risk of a prolonged LOS included patient age 12 to 17 years (odds ratio [OR], 2.43; P<.001) or ≥65 years (OR, 1.46; P=.007); male gender (OR, 1.24; P=.002); Medicare insurance coverage (OR, 1.34; P=.008); use of restraints (OR, 2.25; P=.006); diagnoses of cognitive disorder (OR, 4.62; P<.001) or personality disorder (OR, 3.45; P<.001); transfer to an unaffiliated psychiatric hospital (OR, 22.82; P<.001); ED arrival from 11 pm through 6:59 am (OR, 1.53; P<.001) or on a Sunday (OR, 1.76; P<.001); or ED evaluation in February (OR, 1.59; P=.006), April (OR, 1.66; P=.002), and May (OR, 1.54; P=.007). CONCLUSIONS: Many psychiatric patients had a prolonged ED LOS. Understanding the multiple, patient-specific, ED operational, and seasonal factors that predict an increased LOS will help guide allocation of resources to improve overall ED processes and patient care.
Description Country affiliation: Mongolia
Author Affiliation: Warren MB ( Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN.); Campbell RL ( Department of Emergency, Mayo Clinic, Rochester, MN.); Nestler DM ( Department of Emergency, Mayo Clinic, Rochester, MN.); Pasupathy KS ( Division of Health Care Policy and Research, Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN.); Lohse CM ( Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN.); Koch KA ( Department of Emergency, Mayo Clinic, Rochester, MN.); Schlechtinger E ( Department of Emergency, Mayo Clinic, Rochester, MN.); Schmidt ST ( Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN.); Melin GJ ( Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN. Electronic address: melin.gabrielle@mayo.edu.)
ISSN 07356757
Educational Role Student ♦ Teacher
Age Range above 22 year
Educational Use Reading ♦ Research ♦ Self Learning
Interactivity Type Expositive
Education Level UG and PG
Learning Resource Type Article
Publisher Date 2016-02-01
Publisher Place United States
e-ISSN 15328171
Journal The American Journal of Emergency Medicine
Volume Number 34
Issue Number 2


Source: WHO-Global Index Medicus