scholarly journals Deliberate self-harm in older adults: A national analysis of US emergency department visits and follow-up care

2019 ◽  
Vol 34 (7) ◽  
pp. 1058-1069 ◽  
Author(s):  
Timothy Schmutte ◽  
Mark Olfson ◽  
Ming Xie ◽  
Steven C. Marcus
Keyword(s):  
Older Adults ◽  
Emergency Department ◽  
Emergency Department Visits ◽  
Deliberate Self Harm ◽  
Follow Up Care ◽  
Self Harm ◽  
National Analysis

A comparison of psychiatric and primary care follow-up after emergency department presentations of deliberate self-harm

2018 ◽  
Vol 109 ◽  
pp. 109
Author(s):  
J. Hunter ◽  
R. Maunder ◽  
P. Kurdyak ◽  
A. Wilton ◽  
A. Gruneir ◽  
...  
Keyword(s):  
Primary Care ◽  
Emergency Department ◽  
Deliberate Self Harm ◽  
Self Harm

scholarly journals Minimally Adequate Mental Health Treatment and Mortality in Primary Care Older Adults With Depression and Anxiety

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 864-865
Author(s):  
Helen-Maria Vasiliadis ◽  
Catherine Lamoureux-Lamarche ◽  
Sébastien Grenier ◽  
Pasquale Roberge
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Primary Care ◽  
Health System ◽  
Emergency Department Visits ◽  
Adequate Treatment ◽  
Risk Of Mortality ◽  
Follow Up Care ◽  
System Factors

Abstract Receipt of quality mental health (MH) care can influence mortality. Given the scarce literature on the topic, the aim was to assess the 3-year risk of mortality in older adults (OA) associated with receiving adequate MH treatment for depression/anxiety in an epidemiologic context. The study sample included 358 OA with depression/anxiety recruited in primary care practices and followed prospectively for 3 years. Mortality was assessed from vital statistics data. Adequate care was based on receipt of pharmacotherapy, follow-up care and psychotherapy. Propensity score analysis was carried out where the inverse probability (IPW) of receiving adequate treatment was calculated. Time to event analyses with IPW was used to assess the effect of receipt of adequate MH treatment on the risk of mortality controlling for individual and health system factors. The results showed that receipt of adequate MH treatment reduced the risk of mortality (HR0.44; 95% CI: 0.22 – 0.99). Individual factors that increased mortality were male sex, being single, reduced functional status and cognitive functioning, # physical disorders, current smoking; while exercise reduced risk. Health system factors such as past # of hospitalizations increased the risk; while # of emergency department visits and continuity of care reduced mortality. Finally, treating depression/anxiety with minimal follow-up care and pharmacotherapy or psychotherapy has a significant impact on reducing mortality in OA. Primary care physicians should recognize the important potential impact of years of lives saved when providing quality MH care to OA.

scholarly journals Emergency Department Use and Inpatient Admissions and Costs Among Adolescents With Deliberate Self-Harm: A Five-Year Follow-Up Study

2020 ◽  
Vol 71 (2) ◽  
pp. 136-143 ◽  
Author(s):  
Sidra Goldman-Mellor ◽  
Dwena Phillips ◽  
Paul Brown ◽  
Paul Gruenewald ◽  
Magdalena Cerdá ◽  
...  
Keyword(s):  
Emergency Department ◽  
Emergency Department Use ◽  
Deliberate Self Harm ◽  
Follow Up Study ◽  
Self Harm

scholarly journals NUTRITIONAL RISK PREDICTS HEALTH SERVICES UTILIZATION AND DEATH OVER 1 YEAR: RESULTS FROM THE UAB STUDY OF AGING II

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S347-S347
Author(s):  
David R Buys ◽  
Richard E Kennedy ◽  
Yue Zhang ◽  
Julie Locher ◽  
Cynthia J Brown
Keyword(s):  
Older Adults ◽  
Emergency Department ◽  
Nursing Home ◽  
Health Services ◽  
Community Dwelling ◽  
Emergency Department Visits ◽  
Nutritional Risk ◽  
Nursing Home Admission ◽  
Services Utilization

Abstract Nutritional risk has been demonstrated to be associated with poor health outcomes, increased risk of health services utilization (HSU), and mortality among older adults. The aim of this study was to assess the prospective relationship between nutritional risk; HSU focusing separately on emergency department visits, hospitalization, and nursing home admission; and mortality. Using the University of Alabama-Birmingham Study of Aging II, we examined this relationship among 419 community-dwelling older Alabamians (75+years). We used the Mini-Nutrition Assessment (MNA), a well-validated nutritional risk assessment, which classifies individuals as either well-nourished, at-risk or malnourished, collected at baseline. We assessed HSU by asking about healthcare encounters since the last monthly follow-up call for 12 months and verified death with family reports and official documents. We completed univariate, bivariate, and Cox proportional hazards regression analyses with one-year of follow-up data, adjusting for social support, social isolation, comorbidities, and demographic variables. Accounting for covariates, being either at-risk or malnourished, relative to well-nourished, was associated with emergency department visits (HR: 1.30, 95% CI:1.14,1.48), hospitalization (HR: 1.58, 95% CI:1.37,1.82), nursing home admission (HR: 8.94, 95% CI:3.99,20.02), and mortality (HR: 1.90, 95% CI:1.25,2.88). These findings underscore the growing awareness that nutritional risk, particularly for older adults, is a significant factor affecting their well-being and particularly their ability to continue living in the community. Nutrition assessment, interventions, and services for community-dwelling older adults may lead to a reduction in health care utilization, particularly nursing home placement, and ultimately to reduced healthcare costs to families and taxpayers.

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