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Psychiatric emergencies account for a large proportion of total referrals and admissions yet there has been little research in the United Kingdom into factors associated with admission after emergency psychiatric assessment. We conducted a one year prospective study of all emergency referrals from Borders Region in Scotland. Four hundred and eighty-seven emergencies were assessed and 153 (31%) of these were admitted. The main predictors of admission after stepwise logistic regression analysis were: risk to self (odds ratio 1.76 for each point increment on a five point scale, 95% confidence intervals 1.43 to 2.15), current contact with the psychiatric services (2.46; 1.52, 3.98) and psychotic diagnosis (2.38; 1.47, 3.87). Compared to subjects assessed at home, those assessed at the psychiatric hospital were more likely to be admitted (3.73; 1.99, 6.99) and self-referrals were less likely to be admitted than General Practitioner referrals (0.22; 0.08, 0.55). Our results suggest that future studies of emergency services should investigate and control for both clinical and service variables.

Type

Journal article

Journal

Health Bull (Edinb)

Publication Date

11/1996

Volume

54

Pages

467 - 473

Keywords

Adolescent, Adult, Aged, Demography, Emergencies, Emergency Services, Psychiatric, Female, Humans, Male, Mental Disorders, Middle Aged, Multivariate Analysis, Odds Ratio, Patient Admission, Prospective Studies, Scotland, Socioeconomic Factors