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Jennifer Field Brown, MSN, PhD (05/04), Department of Health Administration, Virginia Commonwealth University, 718 Greensboro Avenue, Virginia Beach, VA 23451, (757)491-7985, jlfield@hsc.vcu.edu
The purpose of this study was to examine the degree to which environmental and economic factors affect an emergency department's psychiatric consultation arrangement and how arrangement influences service effectiveness. The study utilizes a combination of primary and secondary data gathered from several sources (two state ambulatory and inpatient databases, America Hospital Association and Area Resource File data, and a survey of ED administrators). Regression and multilevel structural equation modeling were the chosen methods of analysis. The sample included nonfederal acute care medical-surgical hospitals that have emergency departments in South Carolina and Maryland. Seventy-one facilities responded to the survey resulting in a 69.6% response rate. Respondents were categorized by type of PES arrangement (in-house, contract, or no service) and this characteristic was the focus of subsequent analysis. Records from 66 ED psychiatric patients were randomly selected from each participating hospital. The study confirms that variation in ED PES arrangement exists and has an influence on outcomes. It has important implications for researchers, healthcare administrators, and policy-makers. The results encourage further exploration to confirm the conditions and type of arrangement that are necessary to produce the most promising outcomes for the patient and organization. Healthcare administrators, policy makers, and accreditors may use the findings to direct guidelines that reduce variation and improve effectiveness. This study represents the creative merging of data sources to develop a comprehensive portrayal of psychiatric service utilization. It demonstrates the utility of ambulatory service data encouraging future use of an HCUP emergency service database currently under development.
Learning Objectives: At the conclusion of this presentation, the participant will be able to
Keywords: Emergency Department/Room, Mental Health Services
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.