Toward a redefinition of psychiatric emergency.

摘要: Abstract OBJECTIVE: To compare three methods for rating legitimate use of psychiatric emergency services (PES) in order to develop criteria that can differentiate appropriate from inappropriate PES service requests. METHOD: Ratings visits by treating physicians and ratings the same made during review medical records. STUDY DESIGN: Two previously used identifying justified were compared with physician's same: (1) hospitalization as visit outcome (2) retrospective chart characteristics using traditional medico-surgical "emergent" illness episodes. DATA EXTRACTION METHODS: Data extracted through a physician questionnaire, administrative record review. PRINCIPAL FINDINGS: Agreement between ranged 47.1 percent 74.1 percent. A total 21.7 rated true health "emergencies" definition, while 70.4 "necessary" physicians, 21.0 resulted hospitalization. Acuteness behavioral dyscontrol imminent dangerousness at time common most combinations visits. CONCLUSIONS: The systems employed similar recent studies produce widely varying percentages so classified. However, it does appear likely minimum 25-30 are nonemergent could be triaged other, less costly treatment providers. Proposed which identify "legitimate" room requests includes only patient presentations (a) acute or (b) self others.