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Psychiatric Inpatient Discharge Planning Practices and Attendance at Aftercare Appointments
Thomas E Smith1, Maria Abraham1, Natalia V Bolotnikova1
1Dr. Smith, Dr. Essock, Dr. Olfson, and Dr. Wall are with the Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York (e-mail: smithto@nyspi.columbia.edu ). They are also with the New York State Psychiatric Institute, New York, where Dr. Abraham is affiliated. Ms. Bolotnikova, Ms. Donahue, Ms. Shao, and Dr. Radigan are with the Office of Performance Measurement and Evaluation, New York State Office of Mental Health, Albany.
Objective:
This study examined discharge planning practices by hospital providers for 17,053 psychiatric discharges in New York's statewide Medicaid program.
Methods:
Claims data were linked to information reported to New York State by managed behavioral health care organizations (MBHOs) conducting inpatient utilization reviews. MBHOs documented hospital providers' reports of the presence of three discharge planning practices for each discharge: communicating with an outpatient provider prior to discharge, scheduling an aftercare appointment, and forwarding a discharge summary.
Results:
Hospital providers reported completing at least one of the three discharge planning practices for 85% of discharges. Individuals who received all three discharge planning practices had a higher likelihood of follow-up and kept their first outpatient follow-up visit at almost twice the speed compared with individuals who received none of the practices (hazard ratio=1.96, p<.001).
Conclusions:
This study provided baseline information concerning routine discharge planning practices and their relationship to timeliness of care transitions.
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