Association between continuity of care and attendance of post-discharge follow-up after psychiatric emergency presentation
Abstract The number of accident and emergency (A&E) hospital attendances by young people aged 18 or under with a recorded diagnosis of a psychiatric condition more than tripled between 2010 and 2022. After discharge from the hospital, attendance at follow-up appointments in the community is crit...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Nature Portfolio
2024-02-01
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| Series: | npj Mental Health Research |
| Online Access: | https://doi.org/10.1038/s44184-023-00052-9 |
| _version_ | 1797272781310656512 |
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| author | Ben Hoi-Ching Wong Petrina Chu Paul Calaminus Cathy Lavelle Rafik Refaat Dennis Ougrin |
| author_facet | Ben Hoi-Ching Wong Petrina Chu Paul Calaminus Cathy Lavelle Rafik Refaat Dennis Ougrin |
| author_sort | Ben Hoi-Ching Wong |
| collection | DOAJ |
| description | Abstract The number of accident and emergency (A&E) hospital attendances by young people aged 18 or under with a recorded diagnosis of a psychiatric condition more than tripled between 2010 and 2022. After discharge from the hospital, attendance at follow-up appointments in the community is critical to ensure the safety of young people and optimise the use of clinical resources. A retrospective cohort study was conducted to evaluate the association between follow-up attendance and the continuity of clinicians and clinical teams, using electronic clinical record data from East London NHS Foundation Trust (ELFT), between April 2019 and March 2022. Multi-level mixed effects logistic regression was performed to model the follow-up attendance odds based on whether the same or different clinician and clinical team offered the initial A&E and the community follow-up appointment or whether a crisis team was involved. 3134 A&E presentations by 2368 young people were identified within the study period. Following these presentations, 2091 follow-up appointments in the community were offered. The attendance rate increased by more than three times if the follow-up appointment was offered by the same clinician who saw the young person in A&E (odds ratio (OR) = 3.66; 95% CI 1.65–8.13). Whether the same clinical team provided the community follow-up appointment, or whether a crisis team was involved before discharge made no difference to the likelihood of follow-up attendance. The findings support the importance of the continuity of clinicians in the care of young people in crisis. |
| first_indexed | 2024-03-07T14:34:17Z |
| format | Article |
| id | doaj.art-b89a3aabc35445789ba3fbb6a45bbed1 |
| institution | Directory Open Access Journal |
| issn | 2731-4251 |
| language | English |
| last_indexed | 2024-03-07T14:34:17Z |
| publishDate | 2024-02-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | npj Mental Health Research |
| spelling | doaj.art-b89a3aabc35445789ba3fbb6a45bbed12024-03-05T20:44:51ZengNature Portfolionpj Mental Health Research2731-42512024-02-01311610.1038/s44184-023-00052-9Association between continuity of care and attendance of post-discharge follow-up after psychiatric emergency presentationBen Hoi-Ching Wong0Petrina Chu1Paul Calaminus2Cathy Lavelle3Rafik Refaat4Dennis Ougrin5East London NHS Foundation TrustInstitute of Psychiatry, Psychology & Neuroscience, King’s College LondonEast London NHS Foundation TrustEast London NHS Foundation TrustEast London NHS Foundation TrustEast London NHS Foundation TrustAbstract The number of accident and emergency (A&E) hospital attendances by young people aged 18 or under with a recorded diagnosis of a psychiatric condition more than tripled between 2010 and 2022. After discharge from the hospital, attendance at follow-up appointments in the community is critical to ensure the safety of young people and optimise the use of clinical resources. A retrospective cohort study was conducted to evaluate the association between follow-up attendance and the continuity of clinicians and clinical teams, using electronic clinical record data from East London NHS Foundation Trust (ELFT), between April 2019 and March 2022. Multi-level mixed effects logistic regression was performed to model the follow-up attendance odds based on whether the same or different clinician and clinical team offered the initial A&E and the community follow-up appointment or whether a crisis team was involved. 3134 A&E presentations by 2368 young people were identified within the study period. Following these presentations, 2091 follow-up appointments in the community were offered. The attendance rate increased by more than three times if the follow-up appointment was offered by the same clinician who saw the young person in A&E (odds ratio (OR) = 3.66; 95% CI 1.65–8.13). Whether the same clinical team provided the community follow-up appointment, or whether a crisis team was involved before discharge made no difference to the likelihood of follow-up attendance. The findings support the importance of the continuity of clinicians in the care of young people in crisis.https://doi.org/10.1038/s44184-023-00052-9 |
| spellingShingle | Ben Hoi-Ching Wong Petrina Chu Paul Calaminus Cathy Lavelle Rafik Refaat Dennis Ougrin Association between continuity of care and attendance of post-discharge follow-up after psychiatric emergency presentation npj Mental Health Research |
| title | Association between continuity of care and attendance of post-discharge follow-up after psychiatric emergency presentation |
| title_full | Association between continuity of care and attendance of post-discharge follow-up after psychiatric emergency presentation |
| title_fullStr | Association between continuity of care and attendance of post-discharge follow-up after psychiatric emergency presentation |
| title_full_unstemmed | Association between continuity of care and attendance of post-discharge follow-up after psychiatric emergency presentation |
| title_short | Association between continuity of care and attendance of post-discharge follow-up after psychiatric emergency presentation |
| title_sort | association between continuity of care and attendance of post discharge follow up after psychiatric emergency presentation |
| url | https://doi.org/10.1038/s44184-023-00052-9 |
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