@article{ref1,
title="Effect of a psychiatric emergency department expansion on acute mental health and addiction service use trends in a large urban center",
journal="Psychiatric services",
year="2019",
author="Reid, Nadine and Castel, Saulo and Veldhuizen, Scott and Roberts, Adair and Stergiopoulos, Vicky",
volume="ePub",
number="ePub",
pages="appips201900112-appips201900112",
abstract="OBJECTIVE: This study examined recent growth in demand for acute mental health and addiction (MHA) care in a large urban center and changes in patient flow following the expansion of a psychiatric emergency department (ED). <br><br>METHODS: A retrospective observational design used administrative data in adjusted negative binomial regression models to identify time trends at seven hospitals over a 6-year period in central Toronto. Two-part linear spline models compared trends before and after a psychiatric ED expansion. <br><br>RESULTS: Per capita MHA-related ED visits grew rapidly across the acute care system over the study period, although admissions per MHA ED visit decreased. Expanding a psychiatric ED did not influence overall system-level growth, but it significantly shifted traffic; the annual MHA ED visit growth rate increased at the expanded ED while decreasing at surrounding hospitals. <br><br>CONCLUSIONS: Given increasing demand systemwide, individual hospital ED expansions may be inappropriate; planning should consider the whole system.<p /> <p>Language: en</p>",
language="en",
issn="1075-2730",
doi="10.1176/appi.ps.201900112",
url="http://dx.doi.org/10.1176/appi.ps.201900112"
}