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{
    "pk": 8089,
    "title": "Who's Boarding in the Psychiatric Emergency Service?",
    "subtitle": null,
    "abstract": "Introduction: \nWhen a psychiatric patient in the emergency department requires inpatient admission, but no bed is available, they may become a “boarder.” The psychiatric emergency service (PES) has been suggested as one means to reduce psychiatric boarding, but the frequency and characteristics of adult PES boarders have not been described.\nMethods: \nWe electronically extracted electronic medical records for adult patients presenting to the PES in an urban county safety-net hospital over 12 months. Correlative analyses included Student’s t-tests and multivariate regression.\nResults:\n 521 of 5363 patient encounters (9.7%) resulted in boarding. Compared to non-boarding encounters, boarding patient encounters were associated with diagnoses of a primary psychotic, anxiety, or personality disorder, or a bipolar manic/mixed episode. Boarders were also more likely to be referred by family, friends or providers than self-referred; arrive in restraints; experience restraint/seclusion in the PES; or be referred for involuntary hospitalization. Boarders were more likely to present to the PES on the weekend. Substance use was common, but only tobacco use was more likely associated with boarding status in multivariate analysis.\nConclusion:\n Boarding is common in the PES, and boarders have substantial psychiatric morbidity requiring treatment during extended PES stays. We question the appropriateness of PES boarding for seriously ill psychiatric patients. [West J Emerg Med. 2014;15(6):-0]",
    "language": "en",
    "license": {
        "name": "Creative Commons Attribution-NonCommercial  4.0",
        "short_name": "CC BY-NC 4.0",
        "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNonCommercial — You may not use the material for commercial purposes.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.",
        "url": "https://creativecommons.org/licenses/by-nc/4.0"
    },
    "keywords": [
        {
            "word": "Emergency Psychiatry"
        },
        {
            "word": "boarding"
        },
        {
            "word": "emergency department"
        },
        {
            "word": "health services"
        }
    ],
    "section": "Emergency Department Access",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/44d8x30t",
    "frozenauthors": [
        {
            "first_name": "Scott",
            "middle_name": "Alan",
            "last_name": "Simpson",
            "name_suffix": "",
            "institution": "University of Colorado School of Medicine, Department of Psychiatry, Denver, Colorado",
            "department": "None"
        },
        {
            "first_name": "Jutta",
            "middle_name": "M.",
            "last_name": "Joesch",
            "name_suffix": "",
            "institution": "University of Washington School of Medicine, Department of Psychiatry and Behavioral Sciences, Seattle, Washington",
            "department": "None"
        },
        {
            "first_name": "Imara",
            "middle_name": "I.",
            "last_name": "West",
            "name_suffix": "",
            "institution": "University of Washington School of Medicine, Department of Psychiatry and Behavioral Sciences, Seattle, Washington",
            "department": "None"
        },
        {
            "first_name": "Jagoda",
            "middle_name": "",
            "last_name": "Pasic",
            "name_suffix": "",
            "institution": "University of Washington School of Medicine, Department of Psychiatry and Behavioral Sciences, Seattle, Washington",
            "department": "None"
        }
    ],
    "date_submitted": "2014-01-06T22:20:36Z",
    "date_accepted": "2014-01-06T22:20:36Z",
    "date_published": "2014-06-07T00:25:01Z",
    "render_galley": null,
    "galleys": [
        {
            "label": "",
            "type": "pdf",
            "path": "https://journalpub.escholarship.org/westjem/article/8089/galley/4668/download/"
        }
    ]
}