scholarly journals Association between smoking, and hospital readmission among inpatients with psychiatric illness at an academic inpatient psychiatric facility, 2000–2015

2019 ◽  
Vol 9 ◽  
pp. 100181
Author(s):  
Robert Kagabo ◽  
Jaewhan Kim ◽  
Jon-Kar Zubieta ◽  
Kristi Kleinschmit ◽  
Kolawole Okuyemi
2021 ◽  
pp. 107755872199892
Author(s):  
Morgan C. Shields

The Centers for Medicare and Medicaid Services implemented the Inpatient Psychiatric Facility Quality Reporting Program in 2012, which publicly reports facilities’ performance on restraint and seclusion (R-S) measures. Using data from Massachusetts, we examined whether nonprofits and for-profits responded differently to the program on targeted indicators, and if the program had a differential spillover effect on nontargeted indicators of quality by ownership. Episodes of R-S (targeted), complaints (nontargeted), and discharges were obtained for 2008-2017 through public records requests to the Commonwealth of Massachusetts. Using difference-in-differences estimators, we found no differential changes in R-S between for-profits and nonprofits. However, for-profits had larger increases in overall complaints, safety-related complaints, abuse-related complaints, and R-S-related complaints compared with nonprofits. This is the first study to examine the effects of a national public reporting program among psychiatric facilities on nontargeted measures. Researchers and policymakers should further scrutinize intended and unintended consequences of performance-reporting programs.


2019 ◽  
Vol 9 (1) ◽  
pp. 1-5 ◽  
Author(s):  
Taylor A. Nichols ◽  
Sophie Robert ◽  
David J. Taber ◽  
Jeffrey Cluver

Abstract Introduction Limited evidence exists evaluating the impact of gabapentin in conjunction with benzodiazepines for the management of alcohol withdrawal. A review of outcomes associated with combination gabapentin and benzodiazepine therapy may illuminate new therapeutic uses in clinical practice. Methods This retrospective study evaluated the impact of gabapentin on as-needed use of benzodiazepines in inpatients being treated for acute alcohol withdrawal. The treatment cohort consisted of patients prescribed gabapentin while on a symptom-triggered alcohol withdrawal protocol. The control cohort consisted of patients on symptom-triggered alcohol withdrawal protocol without concurrent gabapentin use. Secondary objectives included length of hospital stay, duration on alcohol withdrawal protocol, frequency of complicated withdrawal, and use of additionally prescribed as-needed or scheduled benzodiazepines. Results The gabapentin cohort was on the alcohol withdrawal protocol for a similar duration, compared with the control cohort (median of 4 [interquartile range: 2,6] days vs 3 [2,4] days, P = .09, respectively). Similarly, the gabapentin cohort required a median of 1 [1,2] benzodiazepine dose for alcohol withdrawal symptoms compared with a median of 1 [1,2] dose in the control cohort, P = .89. No significant difference was found between cohorts for as-needed and scheduled benzodiazepine use. Length of stay in hospital was similar between groups. Discussion These results suggest that gabapentin use, in conjunction with benzodiazepines, impacts neither the time on alcohol withdrawal protocol or the number of benzodiazepine doses required for withdrawal. Larger, prospective studies are needed to detect if gabapentin alters benzodiazepine usage and to better elucidate gabapentin's role in acute alcohol withdrawal.


2020 ◽  
Vol 13 (9) ◽  
pp. e237720
Author(s):  
Firas El-Baba ◽  
Danielle Gabe ◽  
Allan Frank

A 33-year-old man with paranoid schizophrenia and a ventriculoperitoneal (VP) shunt was sent to our institution from an inpatient psychiatric facility due to concerns for the 2019 novel coronavirus (COVID-19). Per the facility, the patient had a fever and non-productive cough. On admission, the patient was afebrile and lacked subjective symptoms. A RNA reverse transcriptase PCR (RNA RT-PCR) test for COVID-19 was positive. A chest X-ray contained a small patchy opacity in the right middle lobe and another in the retrocardiac region concerning for pneumonia. Inflammatory markers were mildly elevated. He remained COVID-19 positive and asymptomatic for 36 days. This case details one asymptomatic carrier’s course with persistently positive COVID-19 nasopharyngeal swabs. It demonstrates that a VP shunt could be a possible predisposition for prolonged viral shedding.


Assessment ◽  
2001 ◽  
Vol 8 (1) ◽  
pp. 67-74 ◽  
Author(s):  
James P. LePagea ◽  
Neil L. Mogge ◽  
William R. Sharpe

CNS Spectrums ◽  
2019 ◽  
Vol 25 (2) ◽  
pp. 223-236
Author(s):  
Barbara E. McDermott ◽  
Katherine Warburton ◽  
Chloe Auletta-Young

Objective.Evidence is clear that the nation is experiencing an increasing number of incompetent to stand trial (IST) admissions to state hospitals. As a result, defendants in need of treatment can wait in jail for weeks for admission for restoration. This study was conducted to better understand this growing population and to inform hospital administration about the characteristics of IST admissions.Methods.The study was conducted at the Department of State Hospitals (DSH) facility in Napa (DSH-Napa), a 1200-bed primarily forensic inpatient psychiatric facility located in northern California. The records of patients found IST and admitted to DSH-Napa for restoration of competence between the dates of 1/1/2009 and 12/31/2016 were eligible for inclusion in the study.Results.There were a total of 3158 unduplicated IST admissions available during the specified time period. Our data indicate that the number of admissions with more than 15 prior arrests increased significantly, from 17.7% in 2009 to 46.4% in 2016. In contrast, the percent of patients reporting prior inpatient psychiatric hospitalization evidenced a consistent decrease over time from over 76% in 2009 to less than 50% in 2016.Conclusion.Our data add to the body of literature on the potential causes of the nationwide increase in competency referrals. The literature is clear that jails and prisons are now the primary provider of the nation’s mental health care. Our data suggest that another system has assumed this role: state hospitals and other providers charged with restoring individuals to competence.


Author(s):  
Swarna Buddha Nayok ◽  
Sathyanarayana MT ◽  
Dhanashree Akshatha H.S.

Introduction: Duration of untreated psychiatric illness is an important component of the final pathway to care for patients. Longer the duration of untreated illness, poorer is the prognosis. Aim: To determine the Duration of Untreated Illness (DUI) along with its correlates, to thus evaluate the pathway to care at our setup. Settings and design: A retrospective cross-sectional study including 228 patients with psychiatric illnesses done at a tertiary care general hospital with a psychiatric setup. Materials: Semi-structured proforma for socio-demographic details, psychiatric diagnosis, duration of illness and duration of untreated illness. Statistical analysis: Sociodemographic details were mainly descriptive and categories compared using Pearson’s Chi square test. Results: The mean age of patients was 36.13 years (Standard Deviation (S.D.) 15.06). The mean DUI was 57.53 months (80.21). Excluding patients with Alcohol Dependence Syndrome (ADS), mean duration of illness was 51.58 months (S.D. 75.50) and DUI was 33.77 months (S.D. 49.11). Mean duration of illness for ADS group was 176.19 months (S.D. 101.20) and DUI was 165.90 months (S.D. 103.07). There was significant association of DUI with occupation (P = .039) and residence (P = .006). While 127 (55.70%) of patients showed to a psychiatrist at first, seventy (30.7%) patients went to faith healers first. Conclusion: It took about 5 years on average to reach a psychiatric facility, which was higher in patients with ADS. Awareness regarding illness model of ADS and other psychiatric disorders along treatment availability may improve DUI and lead to better prognosis.


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