Variation in rates of electroconvulsive therapy use among consultant teams in Edinburgh (1993-1996)

Background: Critics of electroconvulsive therapy (ECT) have expressed concern about variations in ECT use among consultant teams within the same hospital. The aim was to establish whether or not there was a significant variation in rates of ECT use among consultant teams in the same hospital when in-patient workload was taken into account. Methods: A computerised database was used to calculate annual and aggregate rates of ECT use by consultant team, expressed as the number of individual in-patients treated per 100 in-patients discharged between 1993 and 1996. Results: The variation in aggregate rates of ECT use varied approximately 18-fold among the 11 general adult psychiatric teams (P < 0.001), and twofold among the three sector old-age psychiatric teams (P < 0.05). Conclusions: Substantial variation in the rates of ECT use was confirmed, but only among general adult psychiatric teams. Limitations: The extent to which findings from one teaching hospital can be generalised was unknown. Possible explanations of the variations were not assessed. (C) 2000 Elsevier Science B.V. All rights reserved.