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Factors Associated With Outpatient Visit Attendance After Discharge From Inpatient Psychiatric Units in a New York
Jennifer L Humensky1, Omar Fattal1, Rachel Feit1
1Dr. Humensky and Dr. Lewis-Fernández are with the Department of Psychiatry, Columbia University, New York (e-mail: humensk@nyspi.columbia.edu ). Dr. Humensky is also with the Division of Behavioral Health Services and Policy Research and Dr. Lewis-Fernández is also with the Center of Excellence for Cultural Competence, both at the New York State Psychiatric Institute, New York. Dr. Fattal is with the Department of Psychiatry, NYC Health+Hospitals/Bellevue, and with the Department of Psychiatry, New York University (NYU) School of Medicine, both in New York. Ms. Feit is with the Department of Psychiatry, NYU Langone Medical Center, New York. Ms. Mills is with the Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego.
Objective:
A class action lawsuit in New York (Koskinas v. Cuomo) established the right of psychiatric inpatients to receive discharge planning, including arranging outpatient treatment. The attendance rate of the initial outpatient appointment after discharge from inpatient treatment in one city hospital was examined to determine whether rates varied by inpatient unit type.
Methods:
The authors performed retrospective chart review of 1,884 discharges to outpatient care. Multivariate regression models were used to examine the odds of attending the initial appointment.
Results:
Eighty-four percent of patients attended the initial appointment. Higher odds of attendance were associated with case management, living in a shelter or being homeless, general medical comorbidity, and inpatient treatment in a co-occurring disorders unit. Lower odds were associated with being non-Latino black. Inpatient treatment in a Latino unit had no significant effect.
Conclusions:
Hospital characteristics, patient population, and availability of local outpatient services may influence continuity of care.
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