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Salud mental
Print version ISSN 0185-3325
Abstract
MOLINA-LOPEZ, Alejandro et al. Activity indicators through five years in a psychiatric emergency department of voluntary care from a Mexican psychiatric hospital. Salud Ment [online]. 2014, vol.37, n.6, pp.499-508. ISSN 0185-3325.
Background The demand for Psychiatry Emergency Services (PES) has increased during the last years. There is little knowledge about the activity indicators of PES at Mexican psychiatric hospitals. It is necessary to study the activities of these PES, especially the ones which work through voluntary care and with no emergency severity assessment procedure (Triage) before consultation. Objective To describe and compare the activity indicators of a PES within a psychiatric hospital in Mexico City during five years. This hospital offered only voluntary care with no Triage procedure. Material and method The database of all registered PES visits from January 1st, 2004, to December 31th, 2008, was analysed. We determined the overall number of consultations and relative frequencies by trimester, semester, year and five years. After this, indicators were broken down using service variables and psychiatric diagnosis according to the ICD-10; they were then compared with each other. Results A total of n=41 058 consultations were attended during five years, showing an enhancement of 14.8% in the overall PES activity. We observed a significant enhancement of patients' proportion with no compliance to outpatient treatment as well as more night schedule visitations, while references and admission proportions decreased more than 4%. This suggests a "snow ball-like" progressive enhancement of frequent patients of PES with non-urgent conditions. We did not find any changes in psychiatric diagnosis proportion during the study, but there was a significant 9.69% increase in the overall activity of the first semester compared with the second one. Discussion Voluntary care with no Triage procedure tends to enhance the influx of frequent patients with non-urgent conditions, leading to PES overcrowding and disfavoring urgent conditions, specially during the first semester of each year.
Keywords : Activity indicator; psychiatric emergency; triage; service utilization.
