Variation between hospitals in inpatient admission practices for self-harm patients and its impact on repeat presentation

Show simple item record

dc.contributor.author Carroll, R.
dc.contributor.author Corcoran, Paul
dc.contributor.author Griffin, Eve
dc.contributor.author Perry, Ivan J.
dc.contributor.author Arensman, Ella
dc.contributor.author Gunnell, D.
dc.contributor.author Metcalfe, C.
dc.date.accessioned 2019-10-26T07:02:40Z
dc.date.available 2019-10-26T07:02:40Z
dc.date.issued 2016-06-14
dc.identifier.citation Carroll, R., Corcoran, P., Griffin, E., Perry, I., Arensman, E., Gunnell, D. and Metcalfe, C., (2016), 'Variation between hospitals in inpatient admission practices for self-harm patients and its impact on repeat presentation', Social Psychiatry and Psychiatric Epidemiology, 51(11), pp. 1485-1493. DOI: 10.1007/s00127-016-1247-y en
dc.identifier.volume 51 en
dc.identifier.issued 11 en
dc.identifier.startpage 1485 en
dc.identifier.endpage 1493 en
dc.identifier.issn 0933-7954
dc.identifier.uri http://hdl.handle.net/10468/8878
dc.identifier.doi 10.1007/s00127-016-1247-y en
dc.description.abstract Purpose: Self-harm patient management varies markedly between hospitals, with fourfold differences in the proportion of patients who are admitted to a medical or psychiatric inpatient bed. The current study aimed to investigate whether differences in admission practices are associated with patient outcomes (repeat self-harm) while accounting for differences in patient case mix. Methods: Data came from the National Self-Harm Registry Ireland. A prospective cohort of 43,595 self-harm patients presenting to hospital between 2007 and 2012 were included. As well as conventional regression analysis, instrumental variable (IV) methods utilising between hospital differences in rates of hospital admission were used in an attempt to gain unbiased estimates of the association of admission with risk of repeat self-harm. Results: The proportion of self-harm patients admitted to a medical bed varied from 10 to 74 % between hospitals. Conventional regression and IV analysis suggested medical admission was not associated with risk of repeat self-harm. Psychiatric inpatient admission was associated with an increased risk of repeat self-harm in both conventional and IV analyses. This increased risk persisted in analyses stratified by gender and when restricted to self-poisoning patients only. Conclusions: No strong evidence was found to suggest medical admission reduces the risk of repeat self-harm. Models of health service provision that encourage prompt mental health assessment in the emergency department and avoid unnecessary medical admission of self-harm patients appear warranted. Psychiatric inpatient admission may be associated with a heightened risk of repeat self-harm in some patients, but these findings could be biased by residual confounding and require replication. en
dc.format.mimetype application/pdf en
dc.language.iso en en
dc.publisher Springer Berlin Heidelberg en
dc.relation.uri https://link.springer.com/article/10.1007%2Fs00127-016-1247-y
dc.rights ©The Author(s) 2016. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. en
dc.rights.uri http://creativecommons.org/licenses/by/4.0/ en
dc.subject Self-harm en
dc.subject Medical admission en
dc.subject Psychiatric admission en
dc.subject Instrumental variable en
dc.subject Repetition en
dc.subject Confounding en
dc.subject Suicide en
dc.title Variation between hospitals in inpatient admission practices for self-harm patients and its impact on repeat presentation en
dc.type Article (peer-reviewed) en
dc.internal.authorcontactother Paul Corcoran, Department of Epidemiology and Public Health, University College Cork, Cork, Ireland. +353-21-490-3000 Email:pcorcoran@ucc.ie en
dc.internal.availability Full text available en
dc.description.version Published Version en
dc.description.status Peer reviewed en
dc.identifier.journaltitle Social Psychiatry and Psychiatric Epidemiology en
dc.internal.IRISemailaddress pcorcoran@ucc.ie en
dc.identifier.eissn 1433-9285


Files in this item

This item appears in the following Collection(s)

Show simple item record

©The Author(s) 2016. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. Except where otherwise noted, this item's license is described as ©The Author(s) 2016. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
This website uses cookies. By using this website, you consent to the use of cookies in accordance with the UCC Privacy and Cookies Statement. For more information about cookies and how you can disable them, visit our Privacy and Cookies statement