Williams R, Farquharson L, Rhodes E, Dang M, Lindsay N, Quirk A, Baldwin DS, Crawford MJ. Variation in clinical care associated with weekend admission and discharge in psychiatric in-patient units: retrospective case-note review.
BJPsych Open 2020;
6:e103. [PMID:
32878673 PMCID:
PMC7488328 DOI:
10.1192/bjo.2020.88]
[Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 07/21/2020] [Accepted: 08/12/2020] [Indexed: 11/25/2022] Open
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.
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