Are hospitals with both medical/surgical and psychiatric services associated with decreased difficulty in ambulance transfer for patients with self-harm behaviour? A nationwide retrospective observational study using ambulance transfer data in Japan
© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ..
OBJECTIVES: Ambulance diversion and prolonged prehospital transfer time have a significant impact on patient care outcomes. Self-harm behaviour in particular is associated with difficulty in hospital acceptance and longer prehospital transfer time. This study aimed to determine if hospitals with both medical/surgical and psychiatric inpatient beds and high-level emergency care centres are associated with a decreased rate of difficulty in hospital acceptance and shorter prehospital transfer time for patients seeking medical care after self-harm behaviour.
DESIGN AND SETTING: A retrospective observational study using the database of Japanese ambulance dispatch data in 2015.
PARTICIPANTS: Patients who were transferred by ambulances after self-harm behaviour.
INTERVENTIONS: None.
MAIN OUTCOME MEASURES: Multivariable logistic regression analysis and multivariable linear regression analysis were performed to assess whether the presence of hospitals with both medical/surgical and psychiatric inpatient beds and high-level emergency care centres in the city were associated with a decreased rate of difficulty in hospital acceptance and shorter prehospital transfer time.
RESULTS: The number of transfers due to self-harm behaviour in 2015 was 32 849. There was an association between decreased difficulty in hospital acceptance and the presence of high-level emergency care centres (OR 0.63, 95% CI 0.55 to 0.71, p<0.01) and hospitals with both medical/surgical and psychiatric inpatient beds (OR 0.50, 95% CI 0.38 to 0.66, p<0.01). There was a significant reduction in prehospital transfer time in the city with high-level emergency care centres (4.21 min, 95% CI 3.53 to 4.89, p<0.01) and hospitals with medical/surgical and psychiatric inpatient beds (3.46 min, 95% CI 2.15 to 4.77, p<0.01).
CONCLUSION: Hospitals with both medical/surgical and psychiatric inpatient beds and high-level emergency care centres were associated with significant decrease in difficulty in hospital acceptance and shorter prehospital transfer time.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:13 |
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| Enthalten in: |
BMJ open - 13(2023), 2 vom: 24. Feb., Seite e065466 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Chiba, Takuyo [VerfasserIn] |
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| Links: |
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| Themen: |
Accident & emergency medicine |
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| Anmerkungen: |
Date Completed 28.02.2023 Date Revised 20.11.2023 published: Electronic Citation Status MEDLINE |
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| doi: |
10.1136/bmjopen-2022-065466 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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NLM353348392 |
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| 100 | 1 | |a Chiba, Takuyo |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Are hospitals with both medical/surgical and psychiatric services associated with decreased difficulty in ambulance transfer for patients with self-harm behaviour? A nationwide retrospective observational study using ambulance transfer data in Japan |
| 264 | 1 | |c 2023 | |
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| 500 | |a Date Revised 20.11.2023 | ||
| 500 | |a published: Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. | ||
| 520 | |a OBJECTIVES: Ambulance diversion and prolonged prehospital transfer time have a significant impact on patient care outcomes. Self-harm behaviour in particular is associated with difficulty in hospital acceptance and longer prehospital transfer time. This study aimed to determine if hospitals with both medical/surgical and psychiatric inpatient beds and high-level emergency care centres are associated with a decreased rate of difficulty in hospital acceptance and shorter prehospital transfer time for patients seeking medical care after self-harm behaviour | ||
| 520 | |a DESIGN AND SETTING: A retrospective observational study using the database of Japanese ambulance dispatch data in 2015 | ||
| 520 | |a PARTICIPANTS: Patients who were transferred by ambulances after self-harm behaviour | ||
| 520 | |a INTERVENTIONS: None | ||
| 520 | |a MAIN OUTCOME MEASURES: Multivariable logistic regression analysis and multivariable linear regression analysis were performed to assess whether the presence of hospitals with both medical/surgical and psychiatric inpatient beds and high-level emergency care centres in the city were associated with a decreased rate of difficulty in hospital acceptance and shorter prehospital transfer time | ||
| 520 | |a RESULTS: The number of transfers due to self-harm behaviour in 2015 was 32 849. There was an association between decreased difficulty in hospital acceptance and the presence of high-level emergency care centres (OR 0.63, 95% CI 0.55 to 0.71, p<0.01) and hospitals with both medical/surgical and psychiatric inpatient beds (OR 0.50, 95% CI 0.38 to 0.66, p<0.01). There was a significant reduction in prehospital transfer time in the city with high-level emergency care centres (4.21 min, 95% CI 3.53 to 4.89, p<0.01) and hospitals with medical/surgical and psychiatric inpatient beds (3.46 min, 95% CI 2.15 to 4.77, p<0.01) | ||
| 520 | |a CONCLUSION: Hospitals with both medical/surgical and psychiatric inpatient beds and high-level emergency care centres were associated with significant decrease in difficulty in hospital acceptance and shorter prehospital transfer time | ||
| 650 | 4 | |a Observational Study | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a accident & emergency medicine | |
| 650 | 4 | |a epidemiology | |
| 650 | 4 | |a health services administration & management | |
| 650 | 4 | |a mental health | |
| 650 | 4 | |a psychiatry | |
| 700 | 1 | |a Takaku, Reo |e verfasserin |4 aut | |
| 700 | 1 | |a Ito, Erina |e verfasserin |4 aut | |
| 700 | 1 | |a Tamune, Hidetaka |e verfasserin |4 aut | |
| 700 | 1 | |a Rivera, Marisa |e verfasserin |4 aut | |
| 700 | 1 | |a Ikeda, Shunya |e verfasserin |4 aut | |
| 700 | 1 | |a Shiga, Takashi |e verfasserin |4 aut | |
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