Dataset Information

Relationship Between Psychiatric Inpatient Beds and Jail Populations in the United States.

ABSTRACT:

Background

The US criminal justice system has witnessed dramatic increases in its mentally ill population during the past 50 years. The decreasing number of psychiatric beds is one proposed cause and more psychiatric beds may be one solution.

Objective

This study examined the relationships among large changes in local psychiatric bed capacity, local jail inmate populations, and the psychiatric burden at local general hospitals.

Methods

The study used a kernel method to identify abrupt changes in psychiatric bed capacity using the American Hospital Association Survey and Medicare Provider of Services data. Data were aggregated to the hospital referral region-year level and matched to the National Inpatient Sample of hospital discharges 1988-2015 and the Annual Survey of Jails 1985-2014. Subsequent analysis by event study examined the effect of abrupt bed changes on numbers of jail inmates.

Results

Decreases in local psychiatric bed capacity were associated with an average increase of 256.2 jail inmates (95% confidence interval: 3.3-509.1). Increases in psychiatric bed capacity were associated with an average decrease of 199.3 jail inmates (95% confidence interval: -457.4 to 58.8). There was limited evidence for spillovers to general hospitals immediately following decreases in psychiatric beds.

Conclusions

Decreases in local psychiatric bed capacity appear to be associated with subsequent increases in local jail populations. There was no clear evidence of treatment shifting from psychiatric units to local general hospitals. These findings support concerns that a consequence of reducing psychiatric inpatient bed capacity is an increase in the jail population due to more psychiatrically ill inmates, aggravating the challenge of psychiatric treatment delivery within the US criminal justice system.

SUBMITTER: Gao YN

PROVIDER: S-EPMC7887772 | biostudies-literature | 2021 Jan

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Relationship Between Psychiatric Inpatient Beds and Jail Populations in the United States.

Gao Y Nina YN

Journal of psychiatric practice 20210121 1

<h4>Background</h4>The US criminal justice system has witnessed dramatic increases in its mentally ill population during the past 50 years. The decreasing number of psychiatric beds is one proposed cause and more psychiatric beds may be one solution.<h4>Objective</h4>This study examined the relationships among large changes in local psychiatric bed capacity, local jail inmate populations, and the psychiatric burden at local general hospitals.<h4>Methods</h4>The study used a kernel method to iden ...[more]

PMID: 33438865

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Project description:BACKGROUND:Measles is an extremely contagious, vaccine-preventable infection that was officially declared eradicated in the US in 2000. However, measles outbreaks are increasingly occurring in the US. Measles cases have considerable morbidity requiring hospitalization, yet little is known about hospitalization and complications from measles in recent years. OBJECTIVES:To analyze the frequency, predictors, costs and other outcomes of hospitalization for measles in the US. METHODS:The 2002-2016 Nationwide Inpatient Sample, containing a 20% sample of US hospitalizations (n = 96,568,625), was analyzed. Measles and comorbidities were defined by International Classification of Disease, Ninth Revision, Clinical Modification (ICD-9-CM) or ICD-10-CM codes. Multivariable survey logistic regression and linear regression models controlling for sociodemographic demographic factors were constructed to understand associations with organ-specific complications, and cost of care and length of stay, respectively. RESULTS:Overall, 1,018 measles hospitalizations occurred in 2002-2016, and hospitalizations increased over time. In multivariable logistic regression models, measles was associated with higher odds of gastrointestinal, hematologic, infectious, neurologic, ophthalmologic, pulmonary, and renal complications, with the strongest association observed with encephalitis (39.84 [16.51-96.12], P<0.0001). Increased length of stay (LOS) and similar cost of care (mean [95% CI]; 4.8 [4.4-5.4]; $7,438 [$6,446-$8,582]) were observed versus (vs.) all other admissions (4.5 [4.4-4.5]; P<0.01; $7,854 [$7,774-$7,935], P>0.05). There were 34 deaths in hospitalized measles patients; inpatient mortality was numerically higher in those with vs. without measles (proportion ± SEM: 3.3±1.2% vs. 2.3±0.01%, P = 0.333). LIMITATIONS:Lack of outpatient or prescription data. CONCLUSIONS:Measles continues to pose a substantial and preventable health care burden, with serious complications, hospitalization and inpatient mortality. Further studies are needed to improve the prevention and management of measles.

Dataset Information

Relationship Between Psychiatric Inpatient Beds and Jail Populations in the United States.

Background

Objective

Methods

Results

Conclusions

Publications

Relationship Between Psychiatric Inpatient Beds and Jail Populations in the United States.

Similar Datasets

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