ABSTRACT
This study examines the generalizability of a successful care management bridging strategy implemented by a behavioral health managed care organization to reduce readmission in psychiatric and substance use disorder (SUD) populations. The sample included 1724 individuals with a psychiatric or SUD hospitalization or detoxification service within 30-days of a prior SUD or inpatient event; 1243 Medicaid-enrolled adults received the intervention plus usual care, and 481 individuals received only usual care. Results included lower readmission to SUD facilities (p = .0012) and reduced odds of readmission among individuals with a SUD event (OR = 0.49, p = .0006) for the intervention versus the comparison group. Likelihood of readmission was higher for those with dual diagnoses (OR = 1.72, p = .0002) or in urban settings (OR = 1.47, p = .0010), with some evidence of the intervention's success in these populations. Care management bridging strategies may be more effective for individuals who utilize SUD services and others who need help navigating complex systems of care.
Subject(s)
Case Management , Mental Disorders/therapy , Mental Health Services , Patient Readmission/statistics & numerical data , Substance-Related Disorders/therapy , Adolescent , Adult , Diagnosis, Dual (Psychiatry) , Female , Humans , Male , Medicaid , Mental Health Services/statistics & numerical data , Middle Aged , Pennsylvania , Substance Abuse Treatment Centers/statistics & numerical data , United States , Young AdultABSTRACT
This study examines a recovery-focused care management bridging strategy implemented during time of inpatient stay with the goal to increase engagement in aftercare and reduce early psychiatric readmissions. The sample included 195 individuals who received care from a large psychiatric specialty hospital. Eighty-seven individuals were assigned to receive the intervention, while 108 individuals were assigned to the control group. Individuals in the intervention group received a brief interview prior to inpatient discharge plus usual care, and individuals in the control group received usual care. After controlling for age, living situation, and utilization, individuals in the control group were more likely to be readmitted within 30 days of an index readmission than individuals in the intervention group (OR = 2.44, p = .02). Bridging strategies utilized prior to discharge for individuals at higher risk of early mental health inpatient readmission may be used as an effective alternative to more costly interventions.
