Variation in clinical care associated with weekend admission and discharge in psychiatric in-patient units: retrospective case-note review
Williams, R., Farquharson, L., Rhodes, E., Dang, M., Lindsay, N., Quirk, A., Baldwin, D. S. and Crawford, M. J. 2020. Variation in clinical care associated with weekend admission and discharge in psychiatric in-patient units: retrospective case-note review. BJPsych Open. 6 (Art. 103). https://doi.org/10.1192/bjo.2020.88
|Authors||Williams, R., Farquharson, L., Rhodes, E., Dang, M., Lindsay, N., Quirk, A., Baldwin, D. S. and Crawford, M. J.|
Questions have been raised regarding differences in the standards of care that patients receive when they are admitted to or discharged from in-patient units at weekends.
To compare the quality of care received by patients with anxiety and depressive disorders who were admitted to or discharged from psychiatric hospital at weekends with those admitted or discharged during the ‘working week’.
Retrospective case-note review of 3795 admissions to in-patient psychiatric wards in England. Quality of care received by people with depressive or anxiety disorders was compared using multivariable regression analyses.
In total, 795 (20.9%) patients were admitted at weekends and 157 (4.8%) were discharged at weekends. There were minimal differences in quality of care between those admitted at weekends and those admitted during the week. Patients discharged at weekends were less likely to be given sufficient notification (48 h) in advance of being discharged (OR = 0.55, 95% CI 0.39–0.78), to have a crisis plan in place (OR = 0.65, 95% CI 0.46–0.92) or to be given medication to take home (OR = 0.45, 95% CI 0.30–0.66). They were also less likely to have been assessed using a validated outcome measure (OR = 0.70, 95% CI 0.50–0.97).
There is no evidence of a ‘weekend effect’ for patients admitted to psychiatric hospital at weekends, but the quality of care offered to those who were discharged at weekends was relatively poor, highlighting the need for improvement in this area.
|Journal citation||6 (Art. 103)|
|Publisher||Cambridge University Press for Royal College of Psychiatrists|
File Access Level
|Digital Object Identifier (DOI)||https://doi.org/10.1192/bjo.2020.88|
|Online||03 Sep 2020|
|Publication process dates|
|Accepted||12 Aug 2020|
|Deposited||09 Sep 2020|
|Funder||National Institute for Health Research|
|Royal College of Psychiatrists|
|Copyright holder||© 2020 The Authors|
|License: CC BY 4.0|
|File access level: Anyone|
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