Variation in clinical care associated with weekend admission and discharge in psychiatric in-patient units: retrospective case-note review

Article


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
AuthorsWilliams, R., Farquharson, L., Rhodes, E., Dang, M., Lindsay, N., Quirk, A., Baldwin, D. S. and Crawford, M. J.
Abstract

Background

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.

Aims

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’.

Method

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.

Results

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).

Conclusions

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.

JournalBJPsych Open
Journal citation6 (Art. 103)
ISSN2056-4724
Year2020
Publisher Cambridge University Press for Royal College of Psychiatrists
Publisher's version
License
File Access Level
Anyone
Digital Object Identifier (DOI)https://doi.org/10.1192/bjo.2020.88
Publication dates
Online03 Sep 2020
Publication process dates
Accepted12 Aug 2020
Deposited09 Sep 2020
FunderNational Institute for Health Research
Royal College of Psychiatrists
McPin Foundation
Copyright holder© 2020 The Authors
Permalink -

https://repository.uel.ac.uk/item/88561

  • 9
    total views
  • 3
    total downloads
  • 9
    views this month
  • 3
    downloads this month

Export as

Related outputs

Barriers to accessing psychological treatment for medium to high risk male young offenders
McGrath, K., Shaw, J. and Farquharson, L. 2020. Barriers to accessing psychological treatment for medium to high risk male young offenders. The Journal of Forensic Psychiatry & Psychology. 31 (4), pp. 596-612. https://doi.org/10.1080/14789949.2020.1782969
Impact of co‐morbid personality disorder on quality of inpatient mental health services for people with anxiety and depression
Williams, R., Farquharson, L., Rhodes, E., Dang, M., Fitzpatrick, N., Quirk, A., Baldwin, D. S. and Crawford, M. J. 2020. Impact of co‐morbid personality disorder on quality of inpatient mental health services for people with anxiety and depression. Personality and Mental Health. https://doi.org/10.1002/pmh.1484