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Do aftercare services reduce inpatient psychiatric readmissions?
1School of Policy Studies, Applied Research Center, Georgia State University, Atlanta 30302-4039, USA.
Health Services Research
|August 13, 1999
Summary
Aftercare services for children and adolescents generally do not reduce inpatient psychiatric readmissions. Outpatient therapy showed the most impact, while stepdown services had the least effect on reducing readmissions.
Area of Science:
- Child and Adolescent Psychiatry
- Health Services Research
- Mental Health Policy
Background:
- Inpatient psychiatric readmission rates for children and adolescents remain a significant concern.
- Effective aftercare services are crucial for maintaining treatment gains and preventing relapse.
- Understanding the impact of various aftercare components is essential for optimizing mental health interventions.
Purpose of the Study:
- To evaluate the effectiveness of aftercare services in reducing inpatient psychiatric readmissions among children and adolescents.
- To identify specific types of aftercare services that may influence readmission likelihood.
- To explore demographic, diagnostic, and psychosocial factors associated with readmission risk.
Main Methods:
- Analysis of data from the Fort Bragg Demonstration, including 204 children and adolescents discharged from inpatient facilities.
- Utilized hazard modeling (Cox models) to assess the impact of aftercare services on readmission rates.
- Controlled for individual characteristics, including demographics, diagnoses, symptomatology, and psychosocial functioning, using structured interviews and behavior checklists.
Main Results:
- Aftercare services, in general, did not significantly reduce the likelihood of inpatient psychiatric readmission for the studied population.
- Outpatient therapy demonstrated the most substantial effect among specific aftercare services, whereas intermediate stepdown services showed the least impact.
- Certain family and individual characteristics were identified as influencing the probability of readmission.
Conclusions:
- The study findings suggest that current aftercare service models may not be sufficiently effective in preventing readmissions for pediatric psychiatric patients.
- Outpatient therapy appears to be a more impactful component of aftercare than intermediate stepdown services.
- Further research is needed to refine aftercare strategies and address individual and family factors influencing readmission.