Self-admission to inpatient treatment in anorexia nervosa : Impact on healthcare utilization, eating disorder morbidity, and quality of life

• Objective: Little evidence exists concerning the optimal model of inpatient care for patients with longstanding anorexia nervosa (AN). Self-admission has been developed as a treatment tool whereby patients with a history of high healthcare utilization are invited to decide for themselves when brief admission is warranted. The aim of this study was to evaluate the impact of a self-admission program on healthcare utilization, eating disorder morbidity, health-related quality of life (HRQoL), and sick leave for patients with AN.Method: In this cohort study, 29 participants with AN in a Swedish self-admission program were compared to 113 patients with longstanding illness but low previous utilization of inpatient treatment, matched based on age, illness duration, and body-mass index (BMI). Data on healthcare utilization, eating disorder morbidity, and sick leave were obtained from national population and eating disorder quality registers.Results: Participants displayed a >50% reduction in time spent hospitalized at 12-month follow-up, compared to nonsignificant changes in the comparison group. A sensitivity analysis comparing participants to a moderate-utilization comparison subgroup strengthened this observation. In contrast, the approach did not affect participants' BMI or eating disorder morbidity. Regarding HRQoL, mixed results were observed. In terms of sick leave, a beneficial but nonsignificant pattern was seen for participants.Discussion: These findings indicate that self-admission is a viable and helpful tool within a recovery model framework, even though it does not lead to symptom remission. In its proper context, self-admission could potentially transform healthcare from crisis-driven to pre-emptive, and promote autonomy for severely ill patients.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Psykiatri (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Psychiatry (hsv//eng)

Nyckelord

anorexia nervosa

feeding and eating disorders

inpatients

patient admission

patient participation

voluntary admissions

Publikations- och innehållstyp

ref (ämneskategori)

art (ämneskategori)