Strategies For Health Care Organizations to Improve Treatment Engagement, Monitor Success, and Maximize Resources: Effectiveness of a Brief Care Management.
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Strategies For Health Care Organizations to Improve Treatment Engagement, Monitor
Success, and Maximize Resources: Effectiveness of a Brief Care Management
Intervention for Reducing Psychiatric Hospital Readmissions
• In psychiatric settings, it has been recently estimated that 18-67% of patients with serious mental illness (SMI) do not receive treatment immediately following psychiatric hospitalization
• Continued engagement in care following psychiatric hospital discharge may prevent adverse outcomes, including re-hospitalization
• Consequently, there is a pressing need to test strategies that may reduce adverse outcomes by preventing treatment dropout during this transitional period
• Individuals with multiple admissions to psychiatric inpatient service within a year and/or longer lengths of stay during inpatient are at high risk for psychiatric readmission within 30 days
• Interventions and services targeting high-risk individuals are successful in decreasing readmission rate
• In 2011-2012, two interventions aimed at decreasing hospital readmission in high-risk populations were initiated– High-Risk Care Management Focus on
Multiple Readmissions– Critical Time Intervention in Acute Service
• Follow up occurred with the inpatient treatment team to ensure: – Linkage to aftercare providers– Linkage to higher level of community
supports such as:• Acute Service Coordination• Mobile Medications• Community Treatment Team• Diversion and Acute Stabilization Units• Drug and Alcohol Rehabilitation
• During the identified timeframe, 80 adult members received an interview and 80 did not
• Demographics of individuals receiving the interview :– 41% female– 59% white– 41% black/African American– Age ranged from 18-64 years – Average age of 36 years
• The 30-day readmission rate for individuals receiving the interview was 39% lower than the readmission rate for individuals in the non-intervention comparison group – 23.8% versus 38.8%, respectively
• Controlling for member characteristics and prior behavioral health service utilization, individuals in the non-intervention group were significantly more likely to be readmitted than those in the intervention group – aOR 2.38, 95% CI 1.03-5.48, p=.04
Impact of ASC with CTI on readmission• The 30-day readmission rate for individuals
receiving ASC with CTI was significantly lower than the readmission rate for individuals in the comparison cohort– 26.3% versus 46.9%, respectively
• Controlling for member characteristics and prior behavioral health service utilization, individuals in the non-intervention group were significantly more likely to be readmitted than those in the intervention group – aOR 2.92, 95% CI 1.77-4.80, p<.001