West J Emerg Med. 2009 Nov;10(4):268-72.

Emergency department patients with psychiatric complaints return at higher rates than controls.

The western journal of emergency medicine

Troy E Madsen, Anne Bennett, Steven Groke, Anne Zink, Christy McCowan, Alex Hernandez, Stuart Knapp, Deepthi Byreddy, Scott Mattsson, Nichole Quick

PMID: 20046248 PMCID: PMC2791732

Abstract

STUDY OBJECTIVE: At our 35,000 visit/year emergency department (ED), we studied whether patients presenting to the ED with psychiatric complaints were admitted to the hospital at a higher rate than non-psychiatric patients, and whether these patients had a higher rate of reevaluation in the ED within 30 days following the index visit.

METHODS: We reviewed the electronic records of all ED patients receiving a psychiatric evaluation from January to February 2007 and compared these patients to 300 randomly selected patients presenting during the study period for non-psychiatric complaints. Patients were followed for 30 days, and admission rates and return visits were compared.

RESULTS: Two hundred thirty-four patients presented to the ED and were evaluated for psychiatric complaints during the study period. Twenty-four point seven percent of psychiatric patients were admitted upon initial presentation versus 20.7% of non-psychiatric patients (p = 0.258). Twenty-one percent of discharged psychiatric patients returned to the ED within 30 days versus 13.4% of discharged non-psychiatric patients (p=0.041). Patients returning to the ED within 30 days had a 17.1% versus 21.6% admission rate for the psychiatric and non-psychiatric groups, respectively (p=0.485).

CONCLUSION: Patients presenting to this ED with psychiatric complaints were not admitted at a significantly higher rate than non-psychiatric patients. These psychiatric patients did, however, have a significantly higher return rate to the ED when compared to non-psychiatric patients.

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