5139.0: Wednesday, November 15, 2000 - Board 6

Abstract #11066

Pre-Admission Continuity of Care; A New Mental Health Performance Indicator

David Dausey, BA, Epidemiology and Public Health, Yale University, 17 Pardee Place, New Haven, CT 06515, (203) 389-0795, David.Dausey@Yale.edu, Robert Rosenheck, MD, Psychiatry and Public Health, Yale University, Building 8, 950 Campbell Ave, West Haven, CT 06516, and Anthony Lehman, MD, University of Maryland.

The objective of this study was to see how continuity of care prior to an episode of hospitalization affects the duration of hospitalization and access to post-discharge aftercare. We utilized a sample of 46,863 psychiatric inpatients (95.1% male, 4.9% female) ages 18 to 97 discharged from 122 different Veterans Affairs Medical Centers between October 1, 1997 and May 5, 1998. The goal was to determine whether the use of psychiatric outpatient services in the month prior to admission was associated with length of stay, access to outpatient care in the 30 days after discharge, number of outpatient visits in the 6 months after discharge or readmission. Multivariable linear regression was used to analyze data controlling for site, age, race, sex, alcohol and drug use, marital status, dual diagnosis, level of psychiatric disability and distance from a VA hospital. Analyses indicated having at least one visit before admission shortened the average length of stay by 35% (mean length of stay for patients who had at least one visit before admission=26 days, mean length of stay for those with no visits=17 days, p=0.0001). This effect was most pronounced among patients with schizophrenia. However the total number of pre-admission visits, beyond the first, did not further reduce length of stay and there were no significant relationships with other indicators. These findings suggest that patients who have a connection to outpatient care have shorter hospital stays than those who are admitted without such a connection.

Learning Objectives: Articulate continuity of care in mental health Discuss Performance Monitoring and Outcomes research in hospital settings

Keywords: Access to Care, Outcomes Research

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The 128th Annual Meeting of APHA