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Self‐admission to inpatient treatment in anorexia nervosa: Impact on healthcare utilization, eating disorder morbidity, and quality of life
Author(s) -
Strand Mattias,
Bulik Cynthia M.,
Gustafsson Sanna A.,
HausswolffJuhlin Yvonne,
Welch Elisabeth
Publication year - 2020
Publication title -
international journal of eating disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.785
H-Index - 138
eISSN - 1098-108X
pISSN - 0276-3478
DOI - 10.1002/eat.23346
Subject(s) - anorexia nervosa , context (archaeology) , body mass index , medicine , quality of life (healthcare) , inpatient care , eating disorders , health care , affect (linguistics) , psychiatry , cohort , population , psychology , paleontology , nursing , environmental health , communication , economics , biology , economic growth
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.