Intervention to Reduce Inpatient Psychiatric Admission in a Metropolitan City

Abstract

When psychiatric hospitalization is over-used, it represents a financial drain and failure of care. We evaluated implementation and cessation of transporting people medically certified for psychiatric hospitalization to a central psychiatric emergency service for management and re-evaluation of hospitalization need. After implementation, the hospitalization rate declined 89% for 346 transported patients; only four of the nonhospitalized patients presented in crisis again in the next 30 days. Following cessation, the hospitalization rate jumped 59% compared to the preceding year. Costs declined 78.7% per diverted patient. The findings indicate that it is possible to reduce hospitalization and costs, and maintain quality care.

Implementing Level of Care Criteria for Supported Housing in One Urban County

“…This database has been used for previous studies. 8,9 During 2009, there were 2142 people with serious mental illness who resided at least 1 day in a large or small group home with support services paid by Gateway Community Health. Of this group, 83 spent at least 1 day in a large group home during 2009-2011 and were excluded from the analysis.…”

The Crisis in Crisis Intervention: An Analysis of Crisis Care and Community Mental Health in Northwest Ohio

“…(Harris, 2016). A lower capacity of beds for a patient in crisis can result in a practitioner scrambling to find a spot for a patient in crisis (Amirsadri, 2015;Abdulmalik & Thornicroft, 2016).…”

“…For instance, Emergency room physicians in the Amirsadri study often stated their goal was to get psychiatric patients out quickly and to avoid the substance abuse cases (Amirsadri, 2015). Collaboration with community mental health organizations would allow the patient to receive the necessary follow-up care after a crisis and create more personable relationships with their community mental healthcare provider.…”

“…Patients report that hospital type settings are often not positive or helpful during or after a crisis, which is where collaboration comes into play (Harris,2016). As emergency room doctors frequently feel unprepared to diagnose mental illness, collaborating with community mental health agencies would allow them to get a second opinion, receive training, and have community liaisons (Amirsadri, 2015).…”

Does a community based recovery service reduce inpatient bed days?

“…One way to reduce pressure on public mental health service budgets is through reducing inpatient bed days. 1 In line with providing care in the least restrictive environment, increasing options for the delivery of community-based care may be a key pathway to reducing inpatient bed pressures. Across Australia, step up/step down (SUSD) units are being established to provide community-based hospital alternative care during periods of sub-acute relapse for people experiencing sustained mental illness.…”