Patient-initiated brief admission: a single site eight-year retrospective cohort study

Patient-Initiated Brief Admission (PIBA) is an intervention designed to provide constructive crisis management for patients. The purpose of this study was to evaluate outcomes in healthcare utilisation and self-inflicted injuries at one Swedish Hospital where PIBA was implemented in late 2017.

Patients who signed a PIBA-contract between 2017 and 2023 were included in the study. Data on inpatient care, contacts with the psychiatric emergency department and self-inflicted injuries that resulted in contact with medical care were collected from patients' medical records. Effects of PIBA were assessed using paired t-tests, comparing pre-post changes 0.5, 1 and 2 years, from initiation of PIBA-contract, respectively.

Data from a total of 38 patients were analysed. There was a marked decrease in inpatient care from voluntary admissions in the first six months after initiation of PIBA. There was also a significant decrease in number of contacts with the psychiatric emergency department (for all patients) in the 1-year pre-post comparison, but not for the 0.5- and 2-year pre-post comparisons. There were no significant reductions in compulsory inpatient care or self-inflicted injuries in our cohort. Patients with contracts extending over several years appeared stable, on average, in their use of care and prevalence of intoxications.

The main effect on inpatient care after initiation of PIBA was a reduction in voluntary admissions, coinciding with a shift from voluntary admissions in favour of PIBA. The results support a more widespread utilisation of PIBA from a health-economic perspective.