Returning to the emergency department: a retrospective analysis of mental health re-presentations among young people in New South Wales, Australia.

Autor:	Cullen P; School of Population Health, University of New South Wales, Sydney, New South Wales, Australia patricia.cullen@unsw.edu.au.; Ngarruwan Ngadju, First Peoples Health and Wellbeing Research Centre, Australian Health Services Research Institute, University of Wollongong, Wollongong, New South Wales, Australia.; The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia., Leong RN; School of Population Health, University of New South Wales, Sydney, New South Wales, Australia., Liu B; School of Population Health, University of New South Wales, Sydney, New South Wales, Australia., Walker N; School of Population Health, University of New South Wales, Sydney, New South Wales, Australia., Steinbeck K; Discipline of Child and Adolescent Health, Faculty of Medicine and Health, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.; Academic Department of Adolescent Medicine, Children's Hospital at Westmead, Sydney, New South Wales, Australia., Ivers R; School of Population Health, University of New South Wales, Sydney, New South Wales, Australia.; The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia., Dinh M; NSW Institute of Trauma and Injury Management, NSW Agency for Clinical Innovation, Sydney, New South Wales, Australia.; Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.
Jazyk:	angličtina
Zdroj:	BMJ open [BMJ Open] 2022 May 31; Vol. 12 (6), pp. e057388. Date of Electronic Publication: 2022 May 31.
DOI:	10.1136/bmjopen-2021-057388
Abstrakt:	Objectives: This study aimed to describe mental health emergency department (ED) presentations among young people aged 8-26 years in New South Wales, Australia, and to identify key characteristics associated with higher risk of ED mental health re-presentation. Design, Setting and Participants: Retrospective analysis of linked ED data records for mental health presentations between 1 January 2015 and 30 June 2018. Main Outcome Measures: The main outcome was the total number of mental health ED re-presentations within 1 year, following initial presentation. Count regression models were fitted to estimate factors associated with higher likelihood of re-presentations. Results: Forty thousand two hundred and ninety patients were included in the analyses, and 9713 (~25%) re-presented during the following year; 1831 (20%) presented at least three times. On average, patients re-presented 0.61 times per 365 person-days, with average time until first re-presentation of ~92 days but greatest risk of re-presentation within first 30-60 days. Young people with self-harm or suicidal diagnoses at initial presentation were more likely to re-present. Re-presentations were highest among young people <15 years (IRR 1.18 vs ≥20 years old), female (IRR=1.13 vs male), young people residing outside of major cities (IRR 1.08 vs major cities) and Aboriginal and Torres Strait Islander young people (IRR 1.27 vs non-Indigenous). Conclusions: ED mental health re-presentation is high among young people. We demonstrate factors associated with re-presentation that EDs could target for timely, high-quality care that is youth friendly and culturally safe, with appropriate referral pathways into community-based primary and mental healthcare services. (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu