Characteristics and process outcomes of patients presenting to an Australian emergency department for mental health and non-mental health diagnoses

Abstract

Objectives To describe and compare characteristics and process outcomes of patient presentations made to a public hospital emergency department (ED) for mental health (MH) and non-mental health (NMH) diagnoses. Methods This was a descriptive, retrospective cross-sectional study of patients who presented to an Australian hospital ED between September 2011 and September 2012. Demographic, clinical and outcomes data were extracted from the ED information system. MH presentations were compared to NMH presentations. Results Nearly 5% of the 66,678 ED presentations were classified as MH. Compared to the NMH group, a lower proportion in the MH group were seen by a physician within the recommended time frame (39.1% vs. 42.1%, p < 0.001); had a higher admission rate (36.6% vs. 20.1%, p < 0.001); shorter ED Length of Stay (LoS) if admitted (369 vs. 490 min, p < 0.001) and longer ED LoS if not admitted (241 vs. 187 min, p < 0.001). Conclusion Time constraints in the busy ED environment are a potential barrier to the delivery of care for all patients who have the right to timely access to health care. Targeted improvements at the front end of the ED system and output processes between ED, community and inpatient admission are recommended for this site.