Full access
Professional News
Published Online: 15 July 2011

What Patients Want From Emergency Care

Publication: Psychiatric News
Volume 46, Number 14
https://doi.org/10.1176/pn.46.14.psychnews_46_14_12_2
Track CitationsAdd to favorites
As the Rolling Stones said so wisely many years ago, "You can't always get what you want."
This appears especially true if you are a psychiatric patient presenting in an emergency room, said panelists at APA's annual meeting in Honolulu in May.
"People think the hospital has unlimited resources," said Kenneth Certa, M.D., an associate professor of psychiatry and human behavior and director of the residency training program at Thomas Jefferson University Hospital in Philadelphia.
They see a pathway to hospitalization, of course, but sometimes also to food, shelter, clothing, social services, and social contact, said Certa.
However, emergency rooms are overcrowded, and sometimes beds are scarce, he said.
Certa has developed a rule of thumb about these patients' demands: "The more the patient wants to stay in the hospital, the less likely he needs to, and the more he wants to leave, the more likely he needs to stay."
Ellen Gluzman, M.D.
Credit: David Hathcox
To document just how closely patient requests lined up with outcomes, Ellen Gluzman, M.D., a PGY-4 resident at the hospital, reviewed charts of 68 patients seen in the emergency department from April 2010 through June 2010.
Demographically, the average age of these patients was 38, 56 percent were male, 38 percent were white, 56 percent were African American, and 43 percent were homeless.
Overall, these patients' requests were met only 50 percent of the time by emergency department staff, said Gluzman.
The most common request from patients at admission was for inpatient treatment (70 percent), but those were frequently denied, she said. Only 34 percent were admitted.
Moreover, while only 7 percent of patients asked to be discharged, ultimately 64 percent were discharged with an outpatient referral.
Patients who were older, male, African American and homeless and had a substance use diagnosis were more likely to be denied their requests, said Gluzman.
However, diagnoses of mood disorder, psychotic disorder, and cluster B personality disorder had no significant effects on the relationship between request and outcome.
Much more still needs to be learned about the outcomes of patients who don't get what they want, said Gluzman.

Information & Authors

Information

Published In

Go to Psychiatric News
Psychiatric News
Volume 46 • Number 14 • July 15, 2011
Pages: 12

History

Published online: 15 July 2011
Published in print: July 15, 2011

Authors

Metrics & Citations

Metrics

Citations

Export Citations

If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Simply select your manager software from the list below and click Download.

For more information or tips please see 'Downloading to a citation manager' in the Help menu.

Format
Citation style
Style
Copy to clipboard
Tips for downloading citations

View Options

View options

Login options

Already a subscriber? Access your subscription through your login credentials or your institution for full access to this article.

Personal login Institutional Login Open Athens login

Not a subscriber?

Subscribe Now / Learn More

PsychiatryOnline subscription options offer access to the DSM-5-TR® library, books, journals, CME, and patient resources. This all-in-one virtual library provides psychiatrists and mental health professionals with key resources for diagnosis, treatment, research, and professional development.

Need more help? PsychiatryOnline Customer Service may be reached by emailing [email protected] or by calling 800-368-5777 (in the U.S.) or 703-907-7322 (outside the U.S.).

Media

Figures

Other

Tables

Share

Share

Share article link

Share

×

As described within the American Psychiatric Association (APA)'s Privacy Policy and Terms of Use, this website utilizes cookies, including for the purpose of offering an optimal online experience and services tailored to your preferences. Please read the entire Privacy Policy and Terms of Use. By closing this message, browsing this website, continuing the navigation, or otherwise continuing to use the APA's websites, you confirm that you understand and accept the terms of the Privacy Policy and Terms of Use, including the utilization of cookies.