| Autor: |
Bakolis, Ioannis, Stewart, Robert, Baldwin, David S, Beenstock, Jane, Bibby, Paul, Broadbent, Matthew, Cardinal, Rudolf, Chen, Shanquan, Chinnasamy, Karthik, Cipriani, Andrea, Douglas, Simon, Horner, Philip, Jackson, Caroline A, John , Ann, Joyce, Dan W, Lee, Sze Chim, Lewis, Jonathan, McIntosh, Andrew M, Nixon, Neil, Osborn, David PJ, Phiri, Peter, Rathod, Shanaya, Smith, Tanya, Sokal, Rachel, Waller, Robert M, Landau, Sabine |
| Jazyk: |
angličtina |
| Rok vydání: |
2021 |
| Zdroj: |
Bakolis, I, Stewart, R, Baldwin, D S, Beenstock, J, Bibby, P, Broadbent, M, Cardinal, R, Chen, S, Chinnasamy, K, Cipriani, A, Douglas, S, Horner, P, Jackson, C A, John, A, Joyce, D W, Lee, S C, Lewis, J, McIntosh, A M, Nixon, N, Osborn, D PJ, Phiri, P, Rathod, S, Smith, T, Sokal, R, Waller, R M & Landau, S 2021, ' Changes in daily mental health service use and mortality at the commencement and lifting of COVID-19 ‘lockdown’ policy in ten UK sites: a regression discontinuity in time design ', BMJ Open . https://doi.org/10.1136/bmjopen-2021-049721 |
| DOI: |
10.1136/bmjopen-2021-049721 |
| Popis: |
Objectives: To investigate changes in daily mental health service use and mortality in response to the introduction and the lifting of the COVID-19 ‘lockdown’ policy in Spring 2020. Design: A regression discontinuity in time analysis of daily service-level activity. Setting and participants: Mental healthcare data were extracted from ten UK providers. Outcome measures: Daily (weekly for one site) deaths from all causes, referrals and discharges, inpatient care (admissions, discharges, caseloads), and community services (face-to-face/non-face-to-face contacts, caseloads): Adult, Older Adult, and Child/Adolescent Mental Health; Early Intervention in Psychosis; Home Treatment Teams; Liaison/A&E. Data were extracted for 2019 and 2020 to 31st May for all sites, supplemented to 31st July for four sites. Changes around the commencement and lifting of COVID-19 ‘lockdown’ policy (March 23rd and May 10th respectively) were estimated using a regression discontinuity in time design with a difference-in-difference approach generating incidence rate ratios (IRRs), meta-analysed across sites. Results: Pooled estimates for the lockdown transition showed increased daily deaths (IRR 2.31, 95% CI 1.86-2.87), reduced referrals (0.62, 0.55-0.70), and reduced inpatient admissions (0.75, 0.67-0.83) and caseloads (0.85, 0.79-0.91) compared to the pre-lockdown period. All community services saw shifts from face-to-face to non-face-to-face contacts, but varied in caseload changes. Lift-of-lockdown was associated with reduced deaths (0.42, 0.27-0.66), increased referrals (1.36, 1.15-1.60), and increased inpatient admissions (1.21, 1.04-1.42) and caseloads (1.06, 1.00-1.12) compared to the lockdown period. Site-wide activity, inpatient care and community services did not return to pre-lockdown levels after lift-of-lockdown, while number of deaths did. Between-site heterogeneity most often indicated variation in size rather than direction of effect. Conclusions: Mental health service delivery underwent sizeable changes during the first national lockdown, with as-yet unknown and unevaluated consequences. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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