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Abstract
Objective We sought to examine the short-term and long-term impacts of psychiatric hospitalisations among patients of Chinese and South Asian origin.
Design Retrospective population-based cohort study using linked health administrative data.
Setting We examined all adult psychiatric inpatients discharged between 1 April 2006 and 31 March 2014 in Ontario, Canada, who were classified as Chinese, South Asian and all other ethnicities (ie, ‘general population’) using a validated algorithm. We identified 2552 Chinese, 2439 South Asian and 127 142 general population patients.
Primary and secondary outcome measures We examined psychiatric severity measures at admission and discharge and performed multivariable logistic regression analyses to examine 30-day, 180-day and 365-day postdischarge service utilisation and outcomes, comparing each of the ethnic groups with the reference population, after adjustment for age, sex, income, education, marital status, immigration status, community size and discharge diagnosis.
Results Despite presenting to hospital with greater illness severity, Asian psychiatric inpatients had shorter lengths of hospital stay and greater absolute improvements in mental health and functional status at discharge compared with other inpatients. After hospitalisation, Chinese patients were more likely to visit psychiatrists and South Asian patients were more likely to seek mental healthcare from general practitioners. They were also less likely to have a psychiatric readmission or die 1 year following hospitalisation (adjusted ORChinese=0.87; 95% CI 0.79 to 0.97; adjusted ORSouth Asian=0.82, 95% CI 0.73 to 0.91). Findings were consistent across genders, psychiatric diagnoses and immigrant groups.
Conclusion Once hospitalised, patients of Chinese and South Asian origin fared as well as or better than general population patients at discharge and following discharge, and had a positive trajectory of psychiatric service utilisation.
- Mental Health
- Epidemiology
- Psychiatry
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Footnotes
Contributors MC was the principal investigator and MC and ML were responsible for the conception and design of this study. LF and AN analysed the data and all authors (MC, ML, LF, AN, EG, JZ, PK) interpreted the data. MC and EG drafted the manuscript and all authors (MC, EG, ML, LF, AN, JZ, PK) critically revised it and approved the final manuscript. All authors (MC, EG, JZ, ML, LF, AN, PK) had full access to the study results and assume full responsibility for the accuracy and completeness of the ideas presented. MC is the guarantor and takes responsibility for the integrity of the data and the accuracy of the data analysis.
Funding This study was supported by the Institute for Clinical Evaluative Sciences (ICES, Ontario, Canada), which is funded by an annual grant from the Ontario Ministry of Health and Long- Term Care (MOHLTC). It was also supported by the Mental Health and Addictions Scorecard and Evaluation Framework grant from the MOHLTC (grant number 04601A14-19). However, the opinions, results and conclusions reported in this paper are those of the authors and are independent from the funding sources. No endorsement by ICES or the Ontario MOHLTC is intended or should be inferred. The funders had no role in the design, analysis, interpretation or publication of this study.
Competing interests None declared.
Ethics approval Ethics approval for this study was obtained from the Research Ethics Board at Sunnybrook Health Sciences Centre.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement No additional data are available.