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Archived Comments for: Is psychiatric emergency service (PES) use increasing over time?

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  1. Volume of visits v number of separate individual patients s

    Eileen McGinn, independent researcher

    10 February 2009

    This is an interesting study of the rate of and possible reasons for the increase in the volume of visits to EDs for psychiatric patients at four sites with differing types of population changes over a long 11 to 12 year period. Tracking the volume of visits as was done in this study is instructive. However, as the authors note toward the end of the article, more visits many not correlate with a larger population or even with a larger number of individual patients if a relatively few patients make many or more visits than most other patients. So a higher volume of visits is not directly tied to size or increase in population. More visits to the ED may reflect types of illnesses, effectiveness of treatment and many other socioeconomic characteristics. It is even possible that the prevalence of MI decreased while the number of visits grew, if the treatment is not very good or there is not adequate support in the community. Or the number of patients may have increased due to an increased population but they were adequately cared for and did not attend the ED. The increase may be due to a certain class of drugs or combinations of drugs or an increase in certain other characteristics (elderly men, living alone, unemployed, etc.). The authors do point this out in the article but it may not be very clear to everyone.

    Competing interests

    None declared