Avoidable mortality among psychiatric patients

Area of Science:

• Public Health
• Psychiatry
• Health Services Research

Background:

• Avoidable mortality serves as a critical indicator of healthcare quality.
• Previous research suggests elevated mortality risks in psychiatric populations.

Purpose of the Study:

• To investigate avoidable mortality rates among psychiatric patients in Stockholm County.
• To compare mortality risks (suicide, avoidable, unavoidable, drug side-effects) in psychiatric patients versus the general population.

Main Methods:

• Retrospective cohort study using data from Stockholm County psychiatric hospitals (1981-1985) and the Cause of Death Register (1986-1990).
• Calculation of standardized rate ratios for various mortality indicators.
• Comparison between psychiatric patients and the general Stockholm County population.

Main Results:

• Psychiatric patients exhibited significantly higher risks for avoidable mortality (RR 4.7 for men, 3.8 for women) and suicide (6- to 24-fold increase, higher in women).
• Mortality risks from conditions amenable to medical intervention and potential psychotropic drug side-effects were elevated (RR 7.2 for drug side-effects).
• Risks for 'unavoidable' mortality were also higher (RR 3.4 for men, 3.2 for women).

Conclusions:

• Elevated avoidable mortality and suicide rates, especially in female psychiatric patients, signal potential deficiencies in psychiatric care.
• These findings underscore the need for further investigation into the quality and outcomes of psychiatric services.
• The results emphasize the importance of monitoring avoidable mortality as a key performance indicator in mental healthcare.