Inpatient Volume and Quality of Mental Health Care Among Patients With Unipolar Depression

Rasmussen, Line Ryberg; Mainz, Jan; Jørgensen, Mogens B.; Videbech, Poul

doi:10.1176/appi.ps.201700426

Cited by 4 publications

(23 citation statements)

References 17 publications

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“…Interestingly, this study also found IPFs in the lowest tercile of Medicare psychiatric discharges to have the lowest readmission rates. The positive relationship between volume and outcomes has long been well recognized in many facets of medical care, including psychiatry (51)(52)(53)(54). However, this relationship has not consistently been found for readmissions (32), potentially because greater volume means less time spent with each patient or shorter lengths of stay (32).…”

Section: Discussionmentioning

confidence: 99%

Measures of Care Coordination at Inpatient Psychiatric Facilities and the Medicare 30-Day All-Cause Readmission Rate

Benjenk

Shields

Chen

2020

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Objective: The Medicare Inpatient Psychiatric Facility Quality Reporting (IPFQR) program has required inpatient psychiatric facilities to collect and publicly report a suite of quality measures since late 2012. This study aimed to explore the association between facility-level 30-day riskadjusted all-cause readmission (medical or psychiatric) after psychiatric hospitalization (READM-30-IPF) outcome measure and care coordination process measures in the IPFQR. Methods:This study used psychiatric facility-level performance data from the IPFQR that is publicly reported on the Hospital Compare website and reflects facility performance from July 2015 to June 2017. This study used a cross-sectional design and linear regression models controlling for hospital and community characteristics and state fixed-effects. Results:The mean facility-level 30-day readmission rate was 20% (SD=2%) with substantial variation by facility type, ownership status, rurality, and percent of minority county residents. Regression results showed that facilities with top tercile performance on the 7-day mental health follow-up (FUH-7) measure had readmission rates that were significantly lower than facilities in bottom tercile (Coef=−0.58, p<0.01), although the magnitude of this difference was small. The readmission measure, however, did not vary by facilities' performance on discharge plan creation and transmission measures. Conclusions:Results suggested that facilities have substantial opportunities to reduce readmissions after psychiatric hospitalization. The association between hospital performance on care coordination process measures and the all-cause readmission measure currently included in the IPFQR is minimal. The IPFQR should evaluate whether the measures included in the program are adequately capturing compliance with evidence-based processes and desired outcomes.

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Section: Discussionmentioning

confidence: 99%

Measures of Care Coordination at Inpatient Psychiatric Facilities and the Medicare 30-Day All-Cause Readmission Rate

Benjenk

Shields

Chen

2020

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“…Personen mit der Diagnose Schizophrenie, Schizophrenie und Diabetes oder Depression auf einer Station behandelt wurden, desto größer war die Wahrscheinlichkeit, dass sie eine leitliniengerechte Behandlung erhielten [15][16][17].…”

Section: Dies Wird Auch Von Dänischen Registerstudien Zur Behandlung ...unclassified

Der Einfluss des Behandlungsvolumens psychiatrischer Kliniken auf das Risiko der Anwendung besonderer Sicherungsmaßnahmen

Bramesfeld

Röding

2022

Psychiatr Prax

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Zusammenfassung Ziel Bestimmen des Einflusses des Behandlungsvolumens auf die Häufigkeit und Dauer der Anwendung von Besonderen Sicherungsmaßnahmen (bSm) wie Fixierung und Isolierung. Methode Datenbasis sind krankenhausbezogene Registerdaten aus Niedersachsen der Halbjahre 2/2019 bis 1/2021 zu Fällen, die nach dem Niedersächsischen Gesetz für Psychisch Kranke (NPsychKG) untergebracht sind, zum Anteil der Fälle, die eine bSm erhielten sowie zur Anzahl und kumulativen Dauer von bSm/Fall. Es wurden einfache lineare Regressionsmodelle gerechnet. Ergebnis und Diskussion Mit Zunahme des Behandlungsvolumens von nach NPsychKG untergebrachten Fällen sinkt der Anteil der Fälle, die bSm erhalten. Dieses Ergebnis bleibt bestehen auch wenn statistische Ausreißer aus den Berechnungen herausgelassen werden. Schlussfolgerung Angesichts von Hinweisen, dass auch in der psychiatrischen Versorgung das Behandlungsvolumen mit dem gewünschten Behandlungsziel assoziiert ist, sollte das Spannungsfeld wohnortnahe vollstationäre Versorgung in kleinen Kliniken versus Konzentration von Expertise in Zentren diskutiert werden.

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“…Study II (93) and study III ( 94) comprised all inpatients (18 years old) from the Danish Depression Database with an admission between 1 January 2011 and 31 December 2017. To ensure that only patients with incident depression were included, patients with a registration of a depressive diagnosis in the Danish National Patient Registry up to ten years before their first registration in the Danish Depression Database and all non-incident admissions were excluded.…”

Section: Study II + Iiimentioning

confidence: 99%

“…In the second study inpatient volume was defined as the average annual number of patients with a depressive disorder treated at a psychiatric hospital from January 1, 2011, and December 31, 2016. Inpatient volume was divided into tertiles and defined as low volume (< 267 patients per year), medium volume (268-477 patients per year) and high volume (> 478 patients per year) (93).…”

Section: Study II + Study Iiimentioning

confidence: 99%

“…For the association between hospital inpatient volume and all-cause mortality, suicidal behaviour and readmission, Cox proportional hazards regression analysis with cluster robust variance was used to compute hazard ratios (HR) and causespecific HRs (95% CI) with death as competing risk (93). Inverse probability of treatment weights (IPTW) was used to adjust the effect measures and balance diagnostics were conducted according to Zhang et al (97).…”

Section: Study IImentioning

confidence: 99%

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Disparities in care and outcomes among patients admitted with depression

Rasmussen

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Inpatient Volume and Quality of Mental Health Care Among Patients With Unipolar Depression

Abstract: Admission to very-high-volume psychiatric hospital wards was associated with a greater chance of receiving guideline-recommended process performance measures for care of depression.

Cited by 4 publications

References 17 publications

Measures of Care Coordination at Inpatient Psychiatric Facilities and the Medicare 30-Day All-Cause Readmission Rate

Measures of Care Coordination at Inpatient Psychiatric Facilities and the Medicare 30-Day All-Cause Readmission Rate

Der Einfluss des Behandlungsvolumens psychiatrischer Kliniken auf das Risiko der Anwendung besonderer Sicherungsmaßnahmen

Disparities in care and outcomes among patients admitted with depression

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