Jorge Petit1, Mark Graham1, Barry Granek2, Junghye Jeong3, Qingxian Chen3, Deborah Layman3, Emily Leckman-Westin3,4, Molly Finnerty3,5. 1. Coordinated Behavioral Care, 55 Broadway, Suite 701, New York, NY, 10006, USA. 2. Coordinated Behavioral Care, 55 Broadway, Suite 701, New York, NY, 10006, USA. bgranek@cbcare.org. 3. New York State Office of Mental Health, Bureau of Evidence Based Services and Implementation Science, 330 Fifth Avenue-9th Floor, New York, NY, 10001, USA. 4. School of Public Health, State University of New York, University of Albany, 75 New Scotland Ave, CDPC Unit R, Albany, NY, 12208, USA. 5. New York University Grossman School of Medicine, New York, NY, USA.
Abstract
OBJECTIVE: This study examined the impact of Pathway Home™ (PH) transition services for high utilizers of psychiatric hospitalization on inpatient days and outpatient engagement post-hospital discharge. METHODS: This case series study of forty PH graduates (5/22/2015-8/31/2018) used Medicaid claims to assess psychiatric inpatient days-per-month, average proportion of months with psychiatric emergency room, outpatient, and health home care management services. T-tests compared three time periods: the year prior, during, and after enrollment. RESULTS: Graduates had significantly fewer psychiatric inpatient days/month during (M = 1.84, p < 0.001) and after PH enrollment (M = 1.88, p < 0.001) compared to prior to enrollment (M = 7.1), while emergency services were stable. Outpatient visits increased from 45% prior to 76% during enrollment (p < 0.001) and was sustained on follow-up (67%, p = 0.008). A similar pattern emerged for health home services (32%, 60%, and 50%). CONCLUSION: PH is a promising approach for improving outcomes for high utilizers of psychiatric inpatient services, with sustained impact on follow-up.
OBJECTIVE: This study examined the impact of Pathway Home™ (PH) transition services for high utilizers of psychiatric hospitalization on inpatient days and outpatient engagement post-hospital discharge. METHODS: This case series study of forty PH graduates (5/22/2015-8/31/2018) used Medicaid claims to assess psychiatric inpatient days-per-month, average proportion of months with psychiatric emergency room, outpatient, and health home care management services. T-tests compared three time periods: the year prior, during, and after enrollment. RESULTS: Graduates had significantly fewer psychiatric inpatient days/month during (M = 1.84, p < 0.001) and after PH enrollment (M = 1.88, p < 0.001) compared to prior to enrollment (M = 7.1), while emergency services were stable. Outpatient visits increased from 45% prior to 76% during enrollment (p < 0.001) and was sustained on follow-up (67%, p = 0.008). A similar pattern emerged for health home services (32%, 60%, and 50%). CONCLUSION: PH is a promising approach for improving outcomes for high utilizers of psychiatric inpatient services, with sustained impact on follow-up.
Authors: Florian Walter; Matthew J Carr; Pearl L H Mok; Sussie Antonsen; Carsten B Pedersen; Louis Appleby; Seena Fazel; Jenny Shaw; Roger T Webb Journal: Lancet Psychiatry Date: 2019-06-03 Impact factor: 77.056
Authors: Sherry L Shaffer; Shari L Hutchison; Amanda M Ayers; Richard W Goldberg; Daniel Herman; Deborah A Duch; Jane N Kogan; Lauren Terhorst Journal: Psychiatr Serv Date: 2015-08-03 Impact factor: 3.084