Does physician compensation for declaration of involuntary status increase the likelihood of involuntary admission? A population-level cross-sectional linked administrative database study
| Autor: | Simone N. Vigod, Maria Chiu, Michael Lebenbaum, Laura Holder, Paul Kurdyak |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Adult
Hospitals Psychiatric Male medicine.medical_specialty Poison control Suicide prevention Occupational safety and health Odds 03 medical and health sciences Patient Admission 0302 clinical medicine Physicians Health care Injury prevention Epidemiology Humans Medicine 030212 general & internal medicine Applied Psychology Aged Ontario business.industry Mental Disorders Emergency department Middle Aged 030227 psychiatry Hospitalization Psychiatry and Mental health Cross-Sectional Studies Compensation and Redress Emergency medicine Commitment of Mentally Ill Universal Health Care Female business Administrative Claims Healthcare |
| Zdroj: | Psychological Medicine. 51:1666-1675 |
| ISSN: | 1469-8978 0033-2917 |
| DOI: | 10.1017/s0033291720000392 |
| Popis: | BackgroundThere is substantial variability in involuntary psychiatric admission rates across countries and sub-regions within countries that are not fully explained by patient-level factors. We sought to examine whether in a government-funded health care system, physician payments for filling forms related to an involuntary psychiatric hospitalization were associated with the likelihood of an involuntary admission.MethodsThis is a population-based, cross-sectional study in Ontario, Canada of all adult psychiatric inpatients in Ontario (2009–2015, n = 122 851). We examined the association between the proportion of standardized forms for involuntary admissions that were financially compensated and the odds of a patient being involuntarily admitted. We controlled for socio-demographic characteristics, clinical severity, past-health care system utilization and system resource factors.ResultsInvoluntary admission rates increased from the lowest (Q1, 70.8%) to the highest (Q5, 81.4%) emergency department (ED) quintiles of payment, with the odds of involuntary admission in Q5 being nearly significantly higher than the odds of involuntary admission in Q1 after adjustment (aOR 1.73, 95% CI 0.99–3.01). With payment proportion measured as a continuous variable, the odds of involuntary admission increased by 1.14 (95% CI 1.03–1.27) for each 10% absolute increase in the proportion of financially compensated forms at that ED.ConclusionsWe found that involuntary admission was more likely to occur at EDs with increasing likelihood of financial compensation for invoking involuntary status. This highlights the need to better understand how physician compensation relates to the ethical balance between the right to safety and autonomy for some of the world's most vulnerable patients. |
| Databáze: | OpenAIRE |
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