Does Increasing Emergency Bed Capacity Lead to More Visits? A Pre-Post Study on the Incorporation of a Dedicated Child and Adolescent Psychiatric Area in a Tertiary Hospital's Emergency Department
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https://doi.org/10.31766/revpsij.v42n2a2Keywords:
emergency room visits, emergency service, hospital, healthcare policy, childy psychiatry, adolescent psychiatryAbstract
Introduction: In health policy, Roemer's Law argues that "a hospital bed built is a bed filled". This law has not been studied in child and adolescent psychiatric emergency departments. Objectives: To compare the number and characteristics of child and adolescent emergency visits before and after the incorporation of a unit dedicated to providing urgent psychiatric care exclusively to minors in a tertiary hospital. Methods: A retrospective pre-post study was conducted on all emergency psychiatric visits by minors at Hospital Clínic in Barcelona (Spain) during a 10-month period before and after the implementation of the dedicated area. Univariate variables were compared with T-student, chi-square and Mann-Whitney U tests. A linear regression model was performed to predict the expected variation in visits, using data from previous years (2012–2018). Results: 70 additional visits occurred (866 vs 936, 8% increase). The regression model identified an expected increase of 67.1 visits per year (CI 95% 46.1-88.2, p<0.001). The additional visits therefore fell within the expected range of variation. The average visit duration decreased (3.03h vs 2.75h, p=0.02). Conclusions: It cannot be concluded that the new unit had an effect on the number of visits. The increase may be the result of the age distribution of the studied population (different healthcare-seeking behaviours and dynamics in minors) and the limited timeframe of the study (ten months). The latter suggests the need for a longer-term research focus. The finding of shorter visits might indicate an improvement in the quality of care.
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