“No Abnormality Detected”: A Mixed-Methods Examination of Emergency Department Coding Practices for People in Suicidal Crisis

Figures & data

FIGURE 1. Mixed-methods explanatory sequential design.

TABLE 1. Characteristics of sample presenting to the six EDs examined for suicidal crisis.

Characteristic	N (%)
Sex
Male	6,900 (44.8)
Female	8,492 (55.1)
Non-Binary	10 (0.1)
Not Known	9 (0.1)
Age (Years)
<16	1,244 (8.1%)
≥16-25	5,172 (33.6%)
≥26-35	3,580 (23.2%)
≥36-45	2,265 (14.7%)
≥46-55	1,831 (11.9%)
≥56-65	883 (5.7%)
≥66	436 (2.8%)
Ethnicity^1
Asian or Asian British	66 (0.4%)
Black or Black British	80 (0.5%)
Mixed	105 (0.7%)
Not Known	157 (1.0%)
Not Specified	339 (2.2%)
NULL	104 (0.7%)
Other	149 (1.0%)
White or White British	14,411 (93.5%)

¹ Variables were presented as they were received from each ED. Ethnicity was specified within the participating EDs as displayed above.

TABLE 2. Initial complaints by patients and how they were coded at each Emergency department.

ED Site	Initial Complaint Descriptors		Primary Diagnosis Code N (%)
		ANXIETY DISORDER	DEPRESSIVE DISODER	LACERATION	LEFT BEFORE ASSESSMENT	NO ABNORMALITY DETECTED	SELF-HARM	SUICIDAL	NO CODE ENTERED INTO SYSTEM	OTHER
ED 1 (N = 6,769)	“Self-Injurious Behaviour”; “Suicidal”	267 (3.9%)	1,063 (15.7%)	40 (0.6%)	–	15 (0.2%)	526 (7.8%)	1,916 (28.3%)	922 (13.6%)	2,020 (29.8%)
ED 2 (N = 3,716)	“Self-Harm”; “Suicidal Thoughts”	48 (1.3%)	613 (16.5%)	–	11 (0.3%)	15 (0.4%)	613 (16.5%)	–	416 (4.2%)	2,000 (53.8%)
ED 3 (N = 607)	“Deliberate Self-Harm”	17 (2.8%)	100 (16.5%)	160 (24.6%)	–	42 (6.9%)	4 (0.7%)	–	1 (0.2%)	283 (46.6%)
ED 4 and 5 (N = 2,010)	“Self-Injurious Behaviour”; “Suicidal”; “Suicide Attempt”	50 (2.5%)	692 (34.4%)	–	151 (7.5%)	59 (2.9%)	–	–	8 (0.4%)	1,109 (55.2%)
ED 6(N = 2,30)	“Suicidal Thoughts”	199 (8.6%)	890 (38.5%)	–	111 (4.8%)	304 (13.2%)	–	–	–	805 (34.9%)