Department of Applied Health Research, University College London, London, UK.
University Hospitals Birmingham NHS Foundation Trust, Birmingham, Birmingham, UK.
Emerg Med J. 2020 Dec;37(12):744-751. doi: 10.1136/emermed-2019-209105. Epub 2020 Nov 5.
To describe the population of patients who attend emergency departments (ED) in England for mental health reasons.
Cross-sectional observational study of 6 262 602 ED attendances at NHS (National Health Service) hospitals in England between 1 April 2013 and 31 March 2014. We assessed the proportion of attendances due to psychiatric conditions. We compared patient sociodemographic and attendance characteristics for mental health and non-mental health attendances using logistic regression.
4.2% of ED attendances were attributable to mental health conditions (median 3.2%, IQR 2.6% to 4.1%). Those attending for mental health reasons were typically younger (76.3% were aged less than 50 years), of White British ethnicity (73.2% White British), and resident in more deprived areas (59.9% from the two most deprived Index of Multiple Deprivation quintiles (4 and 5)). Mental health attendances were more likely to occur 'out of hours' (68.0%) and at the weekend (31.3%). Almost two-thirds were brought in by ambulance. A third required admission, but around a half were discharged home.
This is the first national study of mental health attendances at EDs in England. We provide information for those planning and providing care, to ensure that clinical resources meet the needs of this patient group, who comprise 4.2% of attendances. In particular, we highlight the need to strengthen the availability of hospital and community care 'out of hours.'
描述因心理健康问题前往英格兰急诊部（ED）就诊的患者人群。
对 2013 年 4 月 1 日至 2014 年 3 月 31 日期间在英格兰国民保健制度（NHS）医院就诊的 6262602 例 ED 就诊情况进行横断面观察性研究。我们评估了因精神疾病就诊的比例。我们使用逻辑回归比较了心理健康和非心理健康就诊患者的社会人口学和就诊特征。
4.2%的 ED 就诊归因于心理健康状况（中位数为 3.2%，四分位距为 2.6%至 4.1%）。那些因心理健康原因就诊的患者通常年龄较小（76.3%年龄小于 50 岁），为白种英国人种（73.2%为白种英国人），居住在较为贫困的地区（59.9%来自收入剥夺程度最高的两个五分位数指数（4 和 5））。心理健康就诊更可能发生在“非工作时间”（68.0%）和周末（31.3%）。近三分之二是由救护车送来的。三分之一需要住院治疗，但约有一半被送回家。
这是英格兰首次对 ED 心理健康就诊情况进行的全国性研究。我们为那些计划和提供护理的人提供了信息，以确保临床资源满足这一患者群体的需求，他们占就诊人数的 4.2%。特别是，我们强调需要加强非工作时间的医院和社区护理的可用性。
