dc.contributor.author	Arensman, Ella
dc.contributor.author	Griffin, Eve
dc.contributor.author	Daly, Caroline
dc.contributor.author	Corcoran, Paul
dc.contributor.author	Cassidy, Eugene M.
dc.contributor.author	Perry, Ivan J.
dc.contributor.funder	Health Service Executive
dc.date.accessioned	2018-05-02T10:16:23Z
dc.date.available	2018-05-02T10:16:23Z
dc.date.issued	2018
dc.description.abstract	Objective The specific objectives of this study were to examine variation in the care of self-harm patients in hospital settings and to identify the factors that predict recommended next care following self-harm. Methods Data on consecutive presentations to Irish emergency departments ( EDs) involving self-harm from the National Self-Harm Registry Ireland from 2004 to 2012 were utilised. Univariate and multivariate regression analyses were performed to assess the associations between patients' clinical and demographic characteristics, and recommended next care received. Results Across the study period a total 101,904 self-harm presentations were made to hospital EDs, involving 63,457 individuals. Over the course of the study there was a declining number of presentations resulting in patient admission following attendance with self-harm. Recommended next care varied according to hospital location, with general admission rates ranging from 11% to 61% across administrative health regions. Multinomial logistic regression identified that the factor which most strongly affected next care was the presenting hospital. Being male, older age, method, repeat self-harm, time of attendance and residence of the patient were all identified as influencing care received. Psychiatric admission was most common when highly lethal methods of self-harm were used ( OR = 4.00, 95% CI, 3.63 - 4.41). A relatively large proportion of patients left the ED without being seen ( 15%) and the risk of doing so was highest for self-harm repeaters ( 1.64, 1.55 - 1.74 for those with 5+ presentations). Conclusions The extensive hospital variation in recommended next care indicates that management of self-harm patients may be determined more by where they present than by the needs of the patient. The study outcomes underline the need to standardise the clinical management of self-harm patients in general hospital settings.	en
dc.description.sponsorship	Health Service Executive (National Office for Suicide Prevention)	en
dc.description.status	Peer reviewed	en
dc.description.version	Published Version	en
dc.format.mimetype	application/pdf	en
dc.identifier.articleid	e0193587
dc.identifier.citation	Arensman, E., Griffin, E., Daly, C., Corcoran, P., Cassidy, E. and Perry, I. J. (2018) 'Recommended next care following hospital-treated self-harm: patterns and trends over time', PLOS ONE, 13(3), e0193587 (12pp). doi: 10.1371/journal.pone.0193587	en
dc.identifier.doi	10.1371/journal.pone.0193587
dc.identifier.issn	1932-6203
dc.identifier.issued	3
dc.identifier.journaltitle	PLOS ONE	en
dc.identifier.uri	https://hdl.handle.net/10468/5934
dc.identifier.volume	13
dc.language.iso	en	en
dc.publisher	Public Library of Science	en
dc.relation.uri	http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0193587
dc.rights	© 2018, Arensman et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.	en
dc.rights.uri	https://creativecommons.org/licenses/by/4.0/
dc.subject	Self-harm	en
dc.subject	Patients	en
dc.subject	Hospitals	en
dc.subject	Critical care and emergency medicine	en
dc.subject	Ireland	en
dc.subject	Alcohols	en
dc.subject	Irish people	en
dc.subject	Psychological and psychosocial issues	en
dc.title	Recommended next care following hospital-treated self-harm: patterns and trends over time	en
dc.type	Article (peer-reviewed)	en

Recommended next care following hospital-treated self-harm: patterns and trends over time

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