Impact of travel distance on the disposition of patients presenting for emergency psychiatric care

Abstract

For veterans presenting for emergency psychiatric care, this research tested the hypothesis that patients with poor geographic accessibility to ambulatory mental health services would be more likely to be hospitalized. Logistic regression results indicated that distant patients (> 60 miles) were 4.8 times more likely (p < .05) to be admitted for acute psychiatric treatment than were proximal patients (< 60 miles), controlling for clinical and demographic case-mix factors. This finding suggests that the Department of Veterans Affairs might be less effective in its effort to substitute intensive outpatient care in place of expensive inpatient treatment for rural veterans with emergent mental health problems.

Community-Level Risk Factors for Depression Hospitalizations

“…These hospitalizations include patients admitted with either a primary or secondary diagnosis of depression and we speculate that a substantial proportion of these hospitalizations may have been preventable. Although we do not present data here, there is a large literature documenting that a large proportion of inpatient admission are potentially preventable (Booth et al, 1991a, c, Booth, Ludke, Wakefield, Kern, & duMond, b;Fortney, Owen, & Clothier, 1999;Ludke, Booth, & Lewis-Beck, 1993;Smith et al, 1996). Access to high quality specialty mental health outpatient treatment could have potentially prevented the 23.2% of hospitalizations in which depression was the primary reason for admission.…”

Psychiatric Emergency Services: A Review of the Literature and a Proposed Research Agenda

“…Researchers have sought to identify the factors that influence evaluation and treatment decisions (48,49). It appears that nonclinical (sociodemongraphic) factors influence treatment decisions (50,51). Research has examined the types of methods and tools that are used in crisis evaluation (44,(52)(53)(54)(55)(56).…”

Demographic, Clinical, and Geographic Predictors of Placement Disruption among Foster Care Youth Receiving Wraparound Services

“…Studies suggest that costs and disease burden increase as distance from providers increases (Billi et al 2007;Fortney et al 1999). Distance from providers can mean that patients wait longer to receive needed care, or resort to more costly emergency services because they are without access to less expensive community care as problems arise and begin to worsen.…”