OBJECTIVE: The one-year readmission rates for children and youths hospitalized for a psychiatric condition is estimated at 38%. Studies suggest that these high readmission rates result from a lack of aftercare, but evidence is mixed. This study further explored the relationship between aftercare and readmission among children and youths ages five to 24 in Alberta, Canada, by using the same study sample to identify predictors of both outcomes. METHODS: A retrospective analysis using linked administrative data was performed. Records of the index inpatient stay and any subsequent readmissions for a mental health reason between July 1, 2007, and December 31, 2012, were obtained from the Discharge Abstract Database. Data on outpatient aftercare for this sample were obtained from ambulatory care records and a patient-level physician billing database. Rates of aftercare and readmission were calculated. A Cox proportional hazards regression model was used to identify predictors of both outcomes. RESULTS: Overall, 15,628 hospitalizations were identified for 12,728 unique individuals. For these hospitalizations, aftercare services were recorded for 29.4% within one week of discharge and for 54.5% within 30 days. Fourteen percent of hospitalizations resulted in readmission within 90 days. Aftercare was associated with a 32% reduction in readmission. Prior service use, longer hospital stays, higher income, specific diagnoses, female sex, and comorbid mental health conditions were associated with a greater likelihood of aftercare receipt. CONCLUSIONS: Access to community mental health services for children and youths remains a priority. The significant role of aftercare in reducing readmission risk demonstrates the need to improve these services.
OBJECTIVE: The one-year readmission rates for children and youths hospitalized for a psychiatric condition is estimated at 38%. Studies suggest that these high readmission rates result from a lack of aftercare, but evidence is mixed. This study further explored the relationship between aftercare and readmission among children and youths ages five to 24 in Alberta, Canada, by using the same study sample to identify predictors of both outcomes. METHODS: A retrospective analysis using linked administrative data was performed. Records of the index inpatient stay and any subsequent readmissions for a mental health reason between July 1, 2007, and December 31, 2012, were obtained from the Discharge Abstract Database. Data on outpatient aftercare for this sample were obtained from ambulatory care records and a patient-level physician billing database. Rates of aftercare and readmission were calculated. A Cox proportional hazards regression model was used to identify predictors of both outcomes. RESULTS: Overall, 15,628 hospitalizations were identified for 12,728 unique individuals. For these hospitalizations, aftercare services were recorded for 29.4% within one week of discharge and for 54.5% within 30 days. Fourteen percent of hospitalizations resulted in readmission within 90 days. Aftercare was associated with a 32% reduction in readmission. Prior service use, longer hospital stays, higher income, specific diagnoses, female sex, and comorbid mental health conditions were associated with a greater likelihood of aftercare receipt. CONCLUSIONS: Access to community mental health services for children and youths remains a priority. The significant role of aftercare in reducing readmission risk demonstrates the need to improve these services.
Entities:
Keywords:
Admissions & aftercare services; postdischarge services; readmissions, Adolescents/adolescence, Community mental health services, Psychiatric hospitalization
Authors: Matthew S Phillips; Danielle L Steelesmith; John V Campo; Taniya Pradhan; Cynthia A Fontanella Journal: J Am Acad Child Adolesc Psychiatry Date: 2019-06-03 Impact factor: 8.829
Authors: Ejemai Eboreime; Reham Shalaby; Wanying Mao; Ernest Owusu; Wesley Vuong; Shireen Surood; Kerry Bales; Frank P MacMaster; Diane McNeil; Katherine Rittenbach; Arto Ohinmaa; Suzette Bremault-Phillips; Carla Hilario; Russ Greiner; Michelle Knox; Janet Chafe; Jeff Coulombe; Li Xin-Min; Carla McLean; Rebecca Rathwell; Mark Snaterse; Pamela Spurvey; Valerie H Taylor; Susan McLean; Liana Urichuk; Berhe Tzeggai; Christopher McCabe; David Grauwiler; Sara Jordan; Ed Brown; Lindy Fors; Tyla Savard; Mara Grunau; Frank Kelton; Sheila Stauffer; Bo Cao; Pierre Chue; Adam Abba-Aji; Peter Silverstone; Izu Nwachukwu; Andrew Greenshaw; Vincent Israel Opoku Agyapong Journal: BMC Health Serv Res Date: 2022-03-12 Impact factor: 2.655