Trends in inpatient care for psychiatric disorders in NHS hospitals across England, 1998/99-2019/20: an observational time series analysis.


Journal

Social psychiatry and psychiatric epidemiology
ISSN: 1433-9285
Titre abrégé: Soc Psychiatry Psychiatr Epidemiol
Pays: Germany
ID NLM: 8804358

Informations de publication

Date de publication:
May 2022
Historique:
received: 19 07 2021
accepted: 05 12 2021
pubmed: 25 12 2021
medline: 29 4 2022
entrez: 24 12 2021
Statut: ppublish

Résumé

It is unclear how hospitals are responding to the mental health needs of the population in England, against a backdrop of diminishing resources. We aimed to document patterns in hospital activity by psychiatric disorder and how these have changed over the last 22 years. In this observational time series analysis, we used routinely collected data on all NHS hospitals in England from 1998/99 to 2019/20. Trends in hospital admissions and bed days for psychiatric disorders were smoothed using negative binomial regression models with year as the exposure and rates (per 1000 person-years) as the outcome. When linear trends were not appropriate, we fitted segmented negative binomial regression models with one change-point. We stratified by gender and age group [children (0-14 years); adults (15 years +)]. Hospital admission rates and bed days for all psychiatric disorders decreased by 28.4 and 38.3%, respectively. Trends were not uniform across psychiatric disorders or age groups. Admission rates mainly decreased over time, except for anxiety and eating disorders which doubled over the 22-year period, significantly increasing by 2.9% (AAPC = 2.88; 95% CI: 2.61-3.16; p < 0.001) and 3.4% (AAPC = 3.44; 95% CI: 3.04-3.85; p < 0.001) each year. Inpatient hospital activity among children showed more increasing and pronounced trends than adults, including an increase of 212.9% for depression, despite a 63.8% reduction for adults with depression during the same period. In the last 22 years, there have been overall reductions in hospital activity for psychiatric disorders. However, some disorders showed pronounced increases, pointing to areas of growing need for inpatient psychiatric care, especially among children.

Identifiants

pubmed: 34951652
doi: 10.1007/s00127-021-02215-5
pii: 10.1007/s00127-021-02215-5
pmc: PMC8705084
doi:

Types de publication

Journal Article Observational Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

993-1006

Informations de copyright

© 2021. The Author(s).

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Auteurs

Michelle Degli Esposti (M)

Department of Social Policy and Intervention, University of Oxford, Barnett House, 32 Wellington Square, Oxford, OX1 2ER, UK. mdesposti@gmail.com.

Hisham Ziauddeen (H)

Department of Psychiatry, University of Cambridge, Cambridge, CB2 3EB, UK.

Lucy Bowes (L)

Department of Experimental Psychology, University of Oxford, Oxford, OX2 6GG, UK.

Aaron Reeves (A)

Department of Social Policy and Intervention, University of Oxford, Barnett House, 32 Wellington Square, Oxford, OX1 2ER, UK.

Adam M Chekroud (AM)

Department of Psychiatry, Yale University School of Medicine, New Haven, CT, 06510, USA.

David K Humphreys (DK)

Department of Social Policy and Intervention, University of Oxford, Barnett House, 32 Wellington Square, Oxford, OX1 2ER, UK.

Tamsin Ford (T)

Department of Psychiatry, University of Cambridge, Cambridge, CB2 3EB, UK.

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