Abstract
Objective
Our aim in this study was to characterise the relationship between comorbid mental
health diagnosis and diabetes type on inpatient length of stay (LOS).
Methods
This retrospective, chart review study was conducted at a community hospital in Ontario,
Canada. Individuals admitted to the inpatient mental health unit with a reported diagnosis
of type 1 or type 2 diabetes were included in the analysis. Relevant data related
to mental health conditions at admission and LOS were collected from the electronic
health record. Analyses of variance and coviariance were used to determine the impact
on LOS.
Results
A total of 249 encounters were included in the analyses. Overall, individuals with
type 2 diabetes (mean, 14.70 days; standard deviation, 15.75 days) had a significantly
longer LOS than individuals with type 1 diabetes (mean, 8.01 days; standard deviation,
7.27 days). Upon including sociodemographic factors, individuals older in age and
with a most recent admission of <1 year also had a longer LOS. There was no significant
relationship between the most responsible mental health diagnosis and LOS.
Conclusions
Individuals with type 2 diabetes may be more likely to have a longer LOS in inpatient
mental health settings than those with type 1 diabetes. More dedicated support would
be beneficial for this population. Future work should focus on in-depth exploration
of the challenges that lead to the observed LOS.
Résumé
Objectifs
L’objectif de notre étude était de caractériser la relation entre le diagnostic d’un
trouble de santé mentale comorbide et le type de diabète sur la durée du séjour (DDS)
en milieu hospitalier.
Méthodes
Nous avons réalisé cette étude rétrospective de dossiers médicaux d’un hôpital communautaire
en Ontario, au Canada. Pour cette analyse, nous avons sélectionné les individus admis
à l’unité hospitalière de santé mentale qui avaient un diagnostic de diabète de type
1 ou de type 2 selon le système de dossiers médicaux électroniques. Nous avons collecté
les données pertinentes liées aux troubles de santé mentale à l’admission et la DDS
dans les dossiers médicaux électroniques. Nous avons eu recours aux analyses de variance
et de covariance pour déterminer les répercussions de la DDS.
Résultats
Nous avons inclus un total de 249 rencontres dans les analyses. À partir des modèles
de régression linéaire, les individus atteints du diabète de type 2 (moyenne, 14,70
jours; écart type, 15,75 jours) avaient une DDS significativement plus longue que
les individus atteints du diabète de type 1 (moyenne, 8,01 jours; écart type, 7,27
jours). Lors de l’application des facteurs sociodémographiques, les individus plus
âgés et récemment admis depuis < 1 an avaient aussi une DDS plus longue. Il n’y avait
aucune relation significative entre le diagnostic principal de santé mentale et la
DDS.
Conclusions
Les individus atteints du diabète de type 2 sont plus susceptibles d’avoir une plus
longue DDS en milieu hospitalier de santé mentale que ceux atteints du diabète de
type 1. Cette population tirerait avantage d’un soutien plus adapté à leurs besoins
particuliers. D’autres travaux devraient porter sur l’exploration en profondeur des
difficultés qui mènent aux DDS observées.
Keywords
Mots clés
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References
- Statistics Canada. Diabetes. 2017.https://www150.statcan.gc.ca/n1/pub/82-625-x/2018001/article/54982-eng.htmDate accessed: May 31, 2021
- Impact of COVID-19 on routine care for chronic diseases: A global survey of views from healthcare professionals.Diabetes Metab Syndr. 2020; 14: 965-967
- Treat all COVID 19-positive patients, but do not forget those negative with chronic diseases.Intern Emerg Med. 2020; 15: 787-790
- The mental health comorbidities of diabetes.JAMA. 2014; 312: 691-692
- Diabetes and mental health.Can J Diabetes. 2018; 42: S130-S141
- The relationship between mental health, mental illness and chronic physical conditions. 2008.https://ontario.cmha.ca/documents/the-relationship-between-mental-health-mental-illness-and-chronic-physical-conditionsDate accessed: November 8, 2021
- Poor mental health in diabetes: Still a neglected comorbidity.Lancet Diabetes Endocrinol. 2015; 3: 393
- Mental illness in Canada. 2020.https://health-infobase.canada.ca/datalab/mental-illness-blog.htmlDate accessed: May 31, 2021
- Mental health and psychological distress in people with diabetes during COVID-19 [letter to the editor].Metabolism. 2020; 108: 154248
- Serious mental illness and medical comorbidities: Findings from an integrated health care system.J Psychosom Res. 2017; 100: 35-45
- The clinical application of the biopsychosocial model.Am J Psychiatry. 1980; 137: 535-544
- Stepped care in psychological therapies: Access, effectiveness and efficiency. Narrative literature review.Br J Psychiatry. 2005; 186: 11-17
- Screening for mental health comorbidities in a pediatric diabetes clinic setting.Clin Diabetes. 2021; 39: 97-101
- Variations in mortality and length of stay in intensive care units.Ann Intern Med. 1993; 118: 753-761
- Determinants of inpatient psychiatric length of stay in an urban county hospital.Psychiatry Q. 2006; 77: 173-188
- Validating the Mental Health Assessment Protocols (MHAPs) in the Resident Assessment Instrument Mental Health (RAI-MH).J Psychiatr Ment Health Nurs. 2009; 16: 646-653
- Development of the Resident Assessment Instrument---Mental Health (RAI-MH).Hosp Q. 2000; 4: 44-51
- R: A Language and Environment for Statistical Computing. R Foundation for Statistical Computing, Vienna2013
- Average time patients spent (wait and treatment) in emergency department.http://indicatorlibrary.hqontario.ca/indicator/detailed/average-los-ed/en(Accessed XX)Date accessed: February 18, 2022
- From triple to quadruple aim: Care of the patient requires care of the provider.Ann Fam Med. 2014; 12: 573-576
- The family and type 2 diabetes: A framework for intervention.Diabetes Educ. 1998; 24: 599-607
- Psychological conditions in adults with diabetes.Am Psychol. 2016; 71: 552-562
- Association between mental health comorbidity and health outcomes in type 2 diabetes mellitus patients.Sci Rep. 2020; 10: 19583
- The comorbidity burden of type 2 diabetes mellitus: Patterns, clusters and predictions from a large English primary care cohort.BMC Med. 2019; 17: 145
- Length of stay of general psychiatric inpatients in the United States: Systematic review.Adm Policy Ment Health. 2011; 38: 155-168
- Diagnosis of physical and mental health conditions in primary care during the COVID-19 pandemic: A retrospective cohort study.Lancet Public Health. 2020; 5: e543-e550
- Measuring health and disability: Manual for WHO Disability Assessment Schedule WHODAS 2.0.World Health Organization, Geneva2010
Article Info
Publication History
Published online: April 18, 2022
Accepted:
March 29,
2022
Received in revised form:
March 5,
2022
Received:
November 20,
2021
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2022 Canadian Diabetes Association.
