Effect of Scheduling a Post-Discharge Outpatient Mental Health Appointment on the Likelihood of Successful Transition From Hospital to Community-Based Care
Effect of Scheduling a Post-Discharge Outpatient Mental Health Appointment on the Likelihood of Successful Transition From Hospital to Community-Based Care
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DOI：
10.4088/jcp.20m13344
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发表时间：
2020-09-01
影响因子：
5.3
通讯作者：
Olfson, Mark
中科院分区：
文献类型：
--
作者：
Smith, Thomas E.;Haselden, Morgan;Olfson, Mark
目的：本研究对15，520例精神科出院住院患者进行了队列研究，以确定在控制患者、医院和系统特征后，安排门诊心理健康预约作为出院计划的一部分与出院后参加门诊护理之间的关联。方法：2012-2013年纽约州医疗补助和其他行政数据库被用于检查年龄在65岁以下的患者，入住精神病住院部，并被释放到社区。结果包括在出院后7天和30天内参加门诊心理健康服务。安排精神健康门诊预约作为出院计划的一部分是主要的预测变量，潜在的混杂协变量通过调整估计安排门诊预约可能性的倾向评分来解决。在15,520名出院患者中，945人（77%）在出院计划中安排了与心理健康提供者的门诊预约。调整倾向评分后，与未安排门诊预约的患者相比，安排门诊预约的患者在7天（OR = 1.69; 95%CI，1.48-1.94）和30天（OR = 1.65; 95%CI，1.42-1.93）内参加门诊心理健康服务的可能性显著更高。即使在那些有一个低的倾向，有预约安排，安排门诊预约与attending outpatient service.Conclusions：安排门诊心理健康预约是一种有效的和低资源的出院规划的做法，应该是一个重要的目标，住院精神科临床质量的测量和改进。
Objective: This study examined a cohort of 15,520 inpatient psychiatric discharges to determine associations between scheduling an outpatient mental health appointment as part of discharge planning and attending outpatient care following discharge after control for patient, hospital, and system characteristics.Methods: 2012-2013 New York State Medicaid and other administrative databases were used to examine patients who were aged under 65 years, admitted to an inpatient psychiatric unit, and discharged to the community. Outcomes included attending an outpatient mental health service within 7 and 30 days following inpatient discharge. Scheduling a mental health outpatient appointment as part of the discharge plan was the primary predictor variable, and potentially confounding covariates were addressed by adjusting for propensity scores estimating the likelihood of having an outpatient appointment scheduled.Results: Among 15,520 discharged patients, 11,945 (77%) had an outpatient appointment scheduled with a mental health provider as part of their discharge planning. After adjustment for propensity scores, patients who had an outpatient appointment scheduled were significantly more likely to attend an outpatient mental health service within 7 (OR = 1.69; 95% CI, 1.48-1.94) and 30 days (OR = 1.65; 95% CI, 1.42-1.93) compared to patients who did not have an appointment scheduled. Even among those with a low propensity to have an appointment scheduled, scheduling an outpatient appointment was associated with attending outpatient services.Conclusions: Scheduling an outpatient mental health appointment is an effective and low-resource discharge planning practice that should be an important target for inpatient psychiatric clinical quality measurement and improvement.