Richard Hodgson

The prediction of in-patient length of stay for acute psychiatric admissions

Many factors are known to influence length of stay on psychiatric wards. Korner returns were used to ascertain length of stay for all psychiatric admissions for patients aged 16-64 years to acute wards in North Staffordshire 1987-1993. Predictor variables were derived from Korner returns or obtained from the 1991 Census data. Fitting a Cox‘s regression model showed that females, older patients, those with psychotic diagnoses, elective admissions, weekday admissions and admissions from relatively affluent areas had longer lengths of stay. The study demonstrates that survival techniques can be used to model length of stay on acute psychiatric wards. The predictor variables used in the study are readily available and the derived models may have value in service planning, audit and resource allocation and may be relevant to individual patient management.Many factors are known to influence length of stay on psychiatric wards. Korner returns were used to ascertain length of stay for all psychiatric admissions for patients aged 16-64 years to acute wards in North Staffordshire 1987-1993. Predictor variables were derived from Korner returns or obtained from the 1991 Census data. Fitting a Cox‘s regression model showed that females, older patients, those with psychotic diagnoses, elective admissions, weekday admissions and admissions from relatively affluent areas had longer lengths of stay. The study demonstrates that survival techniques can be used to model length of stay on acute psychiatric wards. The predictor variables used in the study are readily available and the derived models may have value in service planning, audit and resource allocation and may be relevant to individual patient management.

Trends and characteristics of deliberate self-harm hospital presentations in an English County.

Background. This study investigates deliberate self-harm (DSH) presentations to Southern Derbyshire hospitals from 1990 to 1997. Methods. Retrospective evaluation of deliberate self-harm rates and socio-demographic variables associated with DSH in 9961 consecutive attendances at Derbys two district general hospitals. Results. A significant rise in the rates of DSH in Derbyshire was noted (82%). The gender ratio has changed, with rising numbers of DSH episodes in males. The ratio of DSH episodes to the total Accident & Emergency (A&E) attendances changed from 1.54 to 2.42, with a 36% (95% CI 32–40%) rise in DSH presentations. Overdose remains the most common method of DSH (F = 85%, M = 78%). Two-thirds of the DSH presentations were first DSH attempts. Conclusions. Overall DSH rates are increasing especially in men. In contrast, official suicide rates have reduced during the same period. The increase in DSH rates has implications for already overworked A&E Departments, as well as other emergency and psychiatric services. Service provision and organisation should be reviewed in light of this increasing demand.

Blood glucose testing

The results reported by Dr Tarrant ( Psychiatric Bulletin , August 2006, 30 , 286–288) on blood glucose testing for adults prescribed atypical antipsychotics are far more impressive than we obtained when we audited prescribing on acute psychiatric wards in four health districts in the West