Effectiveness of a Telephone Support Line to Reduce Hospital Use by Older Patients with Psychiatric Disorders
Autor(a) principal: | |
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Data de Publicação: | 2022 |
Outros Autores: | , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://doi.org/10.25752/psi.16969 |
Resumo: | Background: Hospital-based services, such as emergency departments and in-patient wards, are fundamental resources for provision of acute care but are associated with significant risks and may not fully address the needs of older patients with psychiatric disorders. In order to provide a more flexible approach for continuous management of these complex conditions a telephone support line operated by a nurse was implemented in our psychogeriatric unit. Aims: To evaluate whether this intervention was associated with a reduction in hospital admissions and emergency department visits. Methods: Pre-post test study, involving 903 patients who attended the Old Age Psychiatric Unit (OAPU) three years before and three years after the implementation of the intervention (1.09.2008 to 1.10.2014). A patient*time of follow-up index was calculated to weight the periods under OAPU care in both time lapses. Data were also obtained from medical files regarding demographic variables, number and type of hospital admissions and emergency department visits. Results and Conclusions: In the three-year period prior to the intervention 671.2 patients*years were included (76 ± 7.1 years of age) while after the intervention this reached 2010.1 patients*years (77.8 ± 7 years of age). The intervention was independently found to be associated with a decrease of 43% in psychiatric emergency visits, 54% of non-psychiatric emergency visits, and 61% of non-psychiatric ward admissions. The implementation of this telephone-based program showed to be associated with a significant reduction of hospital-based acute care utilization. Future research should determine if this was coupled with improved health outcomes. |
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Effectiveness of a Telephone Support Line to Reduce Hospital Use by Older Patients with Psychiatric DisordersEficácia da Criação de uma Linha Telefónica de Apoio na Redução da Taxa de Admissão Hospitalar em Doentes Idosos com Patologia PsiquiátricaArtigos OriginaisBackground: Hospital-based services, such as emergency departments and in-patient wards, are fundamental resources for provision of acute care but are associated with significant risks and may not fully address the needs of older patients with psychiatric disorders. In order to provide a more flexible approach for continuous management of these complex conditions a telephone support line operated by a nurse was implemented in our psychogeriatric unit. Aims: To evaluate whether this intervention was associated with a reduction in hospital admissions and emergency department visits. Methods: Pre-post test study, involving 903 patients who attended the Old Age Psychiatric Unit (OAPU) three years before and three years after the implementation of the intervention (1.09.2008 to 1.10.2014). A patient*time of follow-up index was calculated to weight the periods under OAPU care in both time lapses. Data were also obtained from medical files regarding demographic variables, number and type of hospital admissions and emergency department visits. Results and Conclusions: In the three-year period prior to the intervention 671.2 patients*years were included (76 ± 7.1 years of age) while after the intervention this reached 2010.1 patients*years (77.8 ± 7 years of age). The intervention was independently found to be associated with a decrease of 43% in psychiatric emergency visits, 54% of non-psychiatric emergency visits, and 61% of non-psychiatric ward admissions. The implementation of this telephone-based program showed to be associated with a significant reduction of hospital-based acute care utilization. Future research should determine if this was coupled with improved health outcomes.Introdução: Os cuidados de saúde hospitalares, como o serviço de urgência ou serviços de internamento, são recursos fundamentais para a provisão de cuidados a doentes agudos mas estão associados a riscos significativos e podem não responder totalmente às necessidades de pessoas mais velhas com patologia psiquiátrica. Para flexibilizar a gestão clínica destas patologias complexas foi implementada uma linha telefónica de apoio com uma enfermeira na nossa unidade de gerontopsiquiatria. Objectivos: Avaliar se esta intervenção se associou a diminuição dos internamentos hospitalares e episódios de urgência. Métodos: Estudo pré-pós envolvendo 903 doentes seguidos na Unidade de Gerontopsiquiatria três anos antes e três anos após a implementação da intervenção (1.09.2008 a 1.10.2014). Foi calculado um índice doente*tempo para determinar os períodos sob seguimento em ambas as fases do estudo. Os dados foram obtidos nos registos clínicos incluindo variáveis demográficas, número e tipo de internamentos hospitalares e episódios de urgência. Resultados e Conclusões: Durante 3 anos antes da intervenção foram incluídos 671.2 doentes*anos (76 ± 7.1 anos de idade) enquanto após a intervenção foram incluídos 2010.1 doentes*anos (77.8 ± 7 anos de idade). A intervenção associou-se a uma redução de 43% nos episódios de urgência psiquiátrica, 54% de episódios de urgência não psiquiátrica e 61% de internamentos não psiquiátricos. A implementação deste programa baseado no atendimento telefónico esteve associado a uma redução de utilização de cuidados hospitalares agudos. Será necessário determinar se esta redução se deveu a uma melhoria clínica.Departamento de Saúde Mental | Hospital Prof. Doutor Fernando Fonseca, EPE2022-09-07T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articlehttps://doi.org/10.25752/psi.16969eng2182-31461646-091XLopes Albuquerque, Elisabete CarinaFernandes, SandraLagarto, LuísaCerejeira, Joaquiminfo:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2022-09-09T05:45:24Zoai:ojs.revistas.rcaap.pt:article/16969Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T15:48:39.032298Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Effectiveness of a Telephone Support Line to Reduce Hospital Use by Older Patients with Psychiatric Disorders Eficácia da Criação de uma Linha Telefónica de Apoio na Redução da Taxa de Admissão Hospitalar em Doentes Idosos com Patologia Psiquiátrica |
title |
Effectiveness of a Telephone Support Line to Reduce Hospital Use by Older Patients with Psychiatric Disorders |
spellingShingle |
Effectiveness of a Telephone Support Line to Reduce Hospital Use by Older Patients with Psychiatric Disorders Lopes Albuquerque, Elisabete Carina Artigos Originais |
title_short |
Effectiveness of a Telephone Support Line to Reduce Hospital Use by Older Patients with Psychiatric Disorders |
title_full |
Effectiveness of a Telephone Support Line to Reduce Hospital Use by Older Patients with Psychiatric Disorders |
title_fullStr |
Effectiveness of a Telephone Support Line to Reduce Hospital Use by Older Patients with Psychiatric Disorders |
title_full_unstemmed |
Effectiveness of a Telephone Support Line to Reduce Hospital Use by Older Patients with Psychiatric Disorders |
title_sort |
Effectiveness of a Telephone Support Line to Reduce Hospital Use by Older Patients with Psychiatric Disorders |
author |
Lopes Albuquerque, Elisabete Carina |
author_facet |
Lopes Albuquerque, Elisabete Carina Fernandes, Sandra Lagarto, Luísa Cerejeira, Joaquim |
author_role |
author |
author2 |
Fernandes, Sandra Lagarto, Luísa Cerejeira, Joaquim |
author2_role |
author author author |
dc.contributor.author.fl_str_mv |
Lopes Albuquerque, Elisabete Carina Fernandes, Sandra Lagarto, Luísa Cerejeira, Joaquim |
dc.subject.por.fl_str_mv |
Artigos Originais |
topic |
Artigos Originais |
description |
Background: Hospital-based services, such as emergency departments and in-patient wards, are fundamental resources for provision of acute care but are associated with significant risks and may not fully address the needs of older patients with psychiatric disorders. In order to provide a more flexible approach for continuous management of these complex conditions a telephone support line operated by a nurse was implemented in our psychogeriatric unit. Aims: To evaluate whether this intervention was associated with a reduction in hospital admissions and emergency department visits. Methods: Pre-post test study, involving 903 patients who attended the Old Age Psychiatric Unit (OAPU) three years before and three years after the implementation of the intervention (1.09.2008 to 1.10.2014). A patient*time of follow-up index was calculated to weight the periods under OAPU care in both time lapses. Data were also obtained from medical files regarding demographic variables, number and type of hospital admissions and emergency department visits. Results and Conclusions: In the three-year period prior to the intervention 671.2 patients*years were included (76 ± 7.1 years of age) while after the intervention this reached 2010.1 patients*years (77.8 ± 7 years of age). The intervention was independently found to be associated with a decrease of 43% in psychiatric emergency visits, 54% of non-psychiatric emergency visits, and 61% of non-psychiatric ward admissions. The implementation of this telephone-based program showed to be associated with a significant reduction of hospital-based acute care utilization. Future research should determine if this was coupled with improved health outcomes. |
publishDate |
2022 |
dc.date.none.fl_str_mv |
2022-09-07T00:00:00Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://doi.org/10.25752/psi.16969 |
url |
https://doi.org/10.25752/psi.16969 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
2182-3146 1646-091X |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.publisher.none.fl_str_mv |
Departamento de Saúde Mental | Hospital Prof. Doutor Fernando Fonseca, EPE |
publisher.none.fl_str_mv |
Departamento de Saúde Mental | Hospital Prof. Doutor Fernando Fonseca, EPE |
dc.source.none.fl_str_mv |
reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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