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

The western journal of emergency medicine

PubMedID: 20046248

Madsen TE, Bennett A, Groke S, Zink A, McCowan C, Hernandez A, Knapp S, Byreddy D, Mattsson S, Quick N. Emergency department patients with psychiatric complaints return at higher rates than controls. West J Emerg Med. 2009;10(4):268-72.
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.