Aftercare of Psychiatric Patients and Its Relation to Rehospitalization

Winston, Arnold; Pardes, Herbert; Papernik, Daniel S.; Breslin, Linda

doi:10.1176/ps.28.2.118

Cited by 32 publications

(9 citation statements)

References 4 publications

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“…Although several studies have emphasized the importance of aftercare and follow-up services, other studies have not found a relationship between readmission rates and the presence of aftercare (18,19), patients' attitudes toward follow-up (20), or continuity of therapists (21). Despite extensive study of the factors associated with community tenure, the factors that predict successful community living after inpatient care are still only partly understood.…”

Section: Effects Of Patient and Health-system Characteristics On Commmentioning

confidence: 99%

Effects of Patient and Health-System Characteristics on Community Tenure of Discharged Psychiatric Inpatients

Bruffærts¹,

Sabbé²,

Demyttenaere³

2004

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6 68 85 5 O ver the past two decades, the organization and provision of mental health care have changed dramatically. The deinstitutionalization of mental health services has resulted in shorter stays in psychiatric hospitals and in larger numbers of psychiatric patients living in the community (1). Many communities have too few resources to help these patients (2). The number of psychiatric referrals to hospital emergency departments has increased, partly because of the general lack of linkage between institutional and community services (3). This trend has been observed both in the United States and in Europe (4).Previous research has provided consistent evidence that persons with previous use of psychiatric services are among the most frequent users of psychiatric emergency departments (5-10). Moreover, patients who are readmitted to inpatient psychiatric care are often found to have been recently discharged from a psychiatric hospitalization. In previous studies, 24 percent of 262 patients (11) and 38 percent of 128 patients (12) with a recent hospital discharge were readmitted within three to six months. In a study of state hospital patients in Massachusetts, Fisher and colleagues (13) found a 50 percent readmission rate within four years of discharge among 5,610 patients. Early hospital readmission has been related to the presence of mental illnesses with poor prognoses (13-15), to poor quality of patients' social networks, and to patients' difficulties with hygiene at discharge (16).Early readmissions, however, may also reflect the quality of postdischarge treatment and care. Some unplanned psychiatric referrals could be explained by the unexpected and acute progression of the patient's mental illness, but the rest may result because the mentally ill person has been discharged from the hospital too soon or because follow-up in the community is ineffective.Lower readmission rates have been associated with the existence of follow-up services. For example, McIntosh and Worley (17) implemented telephone follow-up and aftercare groups for patients who were discharged from a psychiatric hospitalization. Fifteen months after the implementation of these services, these authors found a readmission rate of

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Section: Effects Of Patient and Health-system Characteristics On Commmentioning

confidence: 99%

Effects of Patient and Health-System Characteristics on Community Tenure of Discharged Psychiatric Inpatients

Bruffærts¹,

Sabbé²,

Demyttenaere³

2004

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“…B. einem re• gelmäßigen Arztbesuch; nur 36-58 % der schizophrenen Patienten erscheinen zum ersten vereinbarten ambulanten Behandlungstermin nach Klinikentlassung (11,68). Die Wahrscheinlichkeit, daß ein beliebiger ambulanter Termin wahrgenommen wird, liegt bei 63-78 % (66,84). Der Mißbrauch von psychoaktiven Drogen scheint mit 48 % (14) unter Schizophrenen deutlich häufiger verbreitet zu sein als in der Gesamtbevölkerung und ist, da er den therapeutischen Bemühungen entgegenwirkt und beispielsweise zu häufigeren Klinikaufenthalten führt (69), ebenfalls als eine Manifestation von Non-Compliance aufzufassen.…”

Section: Definition Von Complianceunclassified

Compliance bei der Therapie schizophrener Patienten mit Neuroleptika - eine Übersicht

Mayer¹,

Soyka²

1992

Fortschr Neurol Psychiatr

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In connection with the efforts to improve the prophylaxis against relapse in schizophrenic patients, the topic of non-compliance to therapy with neuroleptics is gaining interest in scientific research. The importance of this problem has been underestimated in the past. Starting with a review of the current state of research, the article provides an overview of the various determinants of compliance. The conclusions made are discussed in terms of optimizing therapy possibilities. Central to this point are less psychopharmacological options but more process- related aspects of the doctor/patient relationship. Fully informed consent of the patient is aimed at; providing him with detailed information on the purposes and the side-effects of neuroleptic therapy is discussed in terms of its consequences regarding compliant behaviour.

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“…Timely outpatient mental health care following a psychiatric hospitalization is associated with fewer readmissions, more effective transitions to community-based services, and improved mental health outcomes. [18][19][20][21][22][23][24] For more than 10 years, these indicators of mental health care quality have been used to assess clinical performance for all Medicare health plans as well as most commercial and Medicaid managed care plans in the United States. 25…”

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confidence: 99%

Insurance Parity and the Use of Outpatient Mental Health Care Following a Psychiatric Hospitalization

Trivedi

Swaminathan²,

Mor³

2008

JAMA

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Aftercare of Psychiatric Patients and Its Relation to Rehospitalization

Cited by 32 publications

References 4 publications

Effects of Patient and Health-System Characteristics on Community Tenure of Discharged Psychiatric Inpatients

Effects of Patient and Health-System Characteristics on Community Tenure of Discharged Psychiatric Inpatients

Compliance bei der Therapie schizophrener Patienten mit Neuroleptika - eine Übersicht

Insurance Parity and the Use of Outpatient Mental Health Care Following a Psychiatric Hospitalization

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