Association between comorbid mental illness and preceding emergency department visits in unplanned admissions

Area of Science:

• Emergency Medicine
• Psychiatry
• Health Services Research

Background:

• Unplanned hospital admissions place a significant burden on healthcare systems.
• Understanding factors associated with unplanned admissions, such as comorbid mental illness, is crucial for improving patient care and resource allocation.

Purpose of the Study:

• To investigate the association between comorbid mental illness and preceding emergency department (ED) visits in patients experiencing unplanned hospital admissions.
• To determine if patients with mental illness are more likely to have multiple ED visits prior to admission.

Main Methods:

• A retrospective observational study was conducted using data from three tertiary medical facilities in Japan (2017-2020).
• Adult patients admitted via the ED were analyzed. Univariate and multivariable logistic regression models were used to assess the association between mental illness and preceding ED visits within 30 days of admission, adjusting for covariates.

Main Results:

• Out of 15,429 admissions, 5.0% had documented comorbid mental illness.
• Patients with mental illness showed a significantly higher prevalence of preceding ED visits (17.1%) compared to those without (8.8%).
• The adjusted odds ratio for preceding ED visits in patients with mental illness was 2.40 (95% CI 1.97-2.94), indicating a stronger association.

Conclusions:

• Comorbid mental illness is significantly associated with an increased likelihood of preceding emergency department visits before unplanned hospital admission.
• These findings underscore the importance of heightened physician vigilance when discharging patients with mental illness from the ED.
• Enhanced post-discharge care strategies are recommended for patients with mental illness to potentially reduce readmissions and ED utilization.