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Administration and Policy in Mental Health and Mental Health Services Research

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01.09.2010 | Original Paper

Post-Discharge Services and Psychiatric Rehospitalization Among Children and Youth

verfasst von: Sigrid James, Sherma J. Charlemagne, Amanda B. Gilman, Qais Alemi, Rhoda L. Smith, Priya R. Tharayil, Kimberly Freeman

Erschienen in: Administration and Policy in Mental Health and Mental Health Services Research | Ausgabe 5/2010

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Abstract

This study examined risk and determinants of rehospitalization of children and adolescents (n = 186) following a first psychiatric hospitalization. It specifically examined the role of post-discharge services. Data were collected for a 30-month follow-up period through structured telephone interviews with caregivers and case record abstractions. 43% of youth experienced readmissions during the follow-up period. Risk of rehospitalization was highest during the first 30 days following discharge and remained elevated for 3 months. 72% of youth received 284 post-discharge services during the follow-up period, which significantly reduced the risk of rehospitalization. Longer first hospitalizations and a higher risk score at admission increased risk.

Clinical personnel indicated that the discharge diagnosis is more reliable than the admission diagnosis, which is generally considered an initial ‘working’ diagnosis.

It should be noted that we did not include medication usage as a covariate in this analysis as all patients were discharged with medications, most with multiple medications, and many had been on medication prior to their first hospitalization. We also did not include insurance type as 90% of respondents in this sample had private insurance.

These youths did not differ from other youths receiving different combinations of post-discharge services in terms of their clinical severity.

Allison, P. D. (1984). Event history analysis. Bevely Hills, CA: Sage Publications.

Arnold, E. M., Goldston, D. B., Ruggiero, A., Reboussin, B. A., Daniel, S. S., & Hickman, E. A. (2003). Rates and predictors or rehospitalization among formerly hospitalized adolescents. Psychiatric Services, 54(7), 994–998.CrossRefPubMed

Ascher, B. H., Farmer, E. M. Z., Burns, B. J., & Angold, A. (1996). The Child and Adolescent Services Assessment (CASA): Description and psychometrics. Journal of Emotional and Behavioral Disorders, 4, 12–20.CrossRef

Blader, J. C. (2004). Symptom, family, and service predictors of children’s psychiatric rehospitalization within one year of discharge. Journal of the American Academy of Child & Adolescent Psychiatry, 43(4), 440–451.CrossRef

Blader, J. C. (2006). Pharmacotherapy and postdischarge outcomes of child patients admitted for aggressive behavior. Journal of Clinical Psychopharmacology, 26(4), 419–425.CrossRefPubMed

Blader, J. (2007). Longitudinal assessment of parental satisfaction with children’s psychiatric hospitalization. Administration & Policy in Mental Health & Mental Health Services Research, 34(2), 108–115.CrossRef

Bobier, C., & Warwick, M. (2005). Factors associated with readmission to adolescent psychiatric care. Australian and New Zealand Journal of Psychiatry, 39(7), 600–606.PubMed

Brinkmeyer, M., Eyberg, S., Nguyen, M., & Adams, R. (2004). Family engagement, consumer satisfaction and treatment outcome in the new era of child and adolescent in-patient psychiatric care. Clinical Child Psychology & Psychiatry, 9(4), 553–566.CrossRef

Burns, B. J., & Hoagwood, K. (Eds.). (2002). Community treatment for youth: Evidence-based interventions for severe emotional and behavioral disorders. New York: Oxford University Press.

Burns, B. J., Hoagwood, K., & Mrazek, P. J. (1999). Effective treatment for mental disorders in children and adolescents. Clinical Child and Family Psychology Review, 2(4), 199–254.CrossRefPubMed

Case, B. G., Olfson, M., Marcus, S. C., & Siegel, C. (2007). Trends in the inpatient mental health treatment of children and adolescents in US community hospitals between 1990 and 2000. Archives of General Psychiatry, 64, 89–96.CrossRefPubMed

Causey, D. L., McKay, M., Rosenthal, C., & Darnell, C. (1998). Assessment of hospital-related stress in children and adolescents admitted to a psychiatric inpatient unit. Journal of Child & Adolescent Psychiatric Nursing, 11(4), 135–145.CrossRef

Chamberlain, P. (2002). Treatment foster care. In B. J. Burns & K. Hoagwood (Eds.), Community treatment for youth: Evidence-based interventions for severe emotional and behavioral disorders (pp. 117–138). New York: Oxford University Press.

Chung, W., Edgar-Smith, S., Palmer, R., Bartholomew, E., & Delambo, D. (2008). Psychiatric rehospitalization of children and adolescents: Implications for social work intervention. Child and Adolescent Social Work Journal, 25(6), 483–496.CrossRef

Cornsweet-Barber, C. D., Neese, T., Coyne, L., Fultz, J., & Fonagy, P. (2002). The target symptom rating: A brief clinical measure of acute psychiatric symptoms in children and adolescents. Journal of Clinical Child Psychology, 31(2), 181–192.

Daniel, S. S., Goldston, D. B., Harris, A. E., Kelley, A. E., & Palmes, G. K. (2004). Review of literature on aftercare services among children and adolescents. Psychiatric Services, 55(8), 901–912.CrossRefPubMed

Dickey, B., Normand, S. L., Norton, E. C., Rupp, A., & Azeni, H. (2001). Managed care and children’s behavioral health services in Massachusetts. Psychiatric Services, 52(2), 183–188.CrossRefPubMed

Fontanella, C. (2008). The influence of clinical, treatment, and healthcare system characteristics on psychiatric readmission of adolescents. American Journal of Orthopsychiatry, 78(2), 187–198.CrossRefPubMed

Fontanella, C., Early, T., & Phillips, G. (2008). Need or availability? Modeling aftercare decisions for psychiatrically hospitalized adolescents. Children & Youth Services Review, 30(7), 758–773.CrossRef

Fontanella, C., Zuravin, S., & Burry, C. (2006). The effect of a medicaid managed care program on patterns of psychiatric readmission among adolescents: Evidence from Maryland. Journal of Behavioral Health Services & Research, 33(1), 39–52.CrossRef

Foster, E. M. (1999). Do aftercare services reduce inpatient psychiatric readmissions? Health Services Research, 34, 715–736.PubMed

Garland, A. F., Landsverk, J., Hough, R. L., & Ellis-MacLeod, E. (1996). Type of maltreatment as a predictor of mental health service use for children in foster care. Child Abuse and Neglect, 20(8), 675–688.CrossRefPubMed

Garrick, D., & Ewashen, C. (2001). An integrated model for adolescent inpatient group therapy. Journal of Psychiatric and Mental Health Nursing, 8, 165–171.CrossRefPubMed

Harnett, P. H., Loxton, N. J., Sadler, T., Hides, L., & Baldwin, A. (2005). The Health of the Nation Outcome Scales for children and adolescents in an adolescent in-patient sample. Australian and New Zealand Journal of Psychiatry, 39, 129–135.PubMed

Heggestad, T. (2001). Operating conditions of psychiatric hospitals and early admission: Effects of high patient turnover. Acta Psychiatrica Scandinavica, 103, 196–202.CrossRefPubMed

Hendryx, M. S., Urdaneta, M. E., & Borders, T. (1995). The relationship between supply and hospitalization rates for mental illness and substance use disorders. Journal of Health Administration, 2(2), 167–176.CrossRef

Henggeler, S. W., Schoenwald, S. K., Borduin, C. M., Rowland, M. D., & Cunningham, P. B. (1998). Multisystemic treatment of antisocial behavior in children and adolescents. New York: Guilford.

Hurlburt, M. S., Leslie, L. K., & Landsverk, J. (2004). Contextual predictors of mental health service use among children open to child welfare. Archives of General Psychiatry, 61(12), 1217–1224.CrossRefPubMed

James, S. (2004). Why do foster care placements disrupt? An investigation of reasons for placement change in foster care. Social Service Review, 78, 601–627.CrossRef

Lakin, B., Brambila, A., & Sigda, K. (2004). Parental involvement as a factor in the readmission to a residential treatment center. Residential Treatment for Children & Youth, 22(2), 37–52.CrossRef

Lien, L. (2002). Are readmission rates influenced by how psychiatric services are organized? Nordic Journal of Psychiatry, 56, 23–28.CrossRefPubMed

Lyons, J. S., McCulloch, J., & Romansky, J. (2006). Monitoring and managing outcomes in residential treatment: Practice-based evidence in search of evidence-based practice. Journal of the American Academy of Child & Adolescent Psychiatry, 45(2), 247–251.CrossRef

Nierman, P., & Lyons, J. S. (2001). State mental health policy: Shifting resources to the community: Closing the Illinois State Psychiatric Hospital for Adolescents in Chicago. Psychiatric Services, 52, 1157–1159.CrossRefPubMed

Owens, P. L., Thompson, J., Elixhauser, A., & Ryan, K. (2003). Care of children and adolescents in U.S. hospitals. Rockville (MD): Agency for Healthcare. Research and Quality, HCUP Fact Book No. 4.

Parham, C., Reid, S., & Hamer, R. (1987). A long-range follow-up study of former inpatients at a children’s psychiatric hospital. Child Psychiatry and Human Development, 17, 199–209.PubMed

Pavkov, T. W., Goerge, R. M., & Lee, B. J. (1997). State hospital reentry among youth with serious emotional disturbance: A longitudinal analysis. Journal of Child and Family Studies, 6(3), 373–383.CrossRef

Pfeffer, C. R., Peskin, J. R., & Siefker, C. A. (1992). Suicidal children grown up–psychiatric-treatment during follow-up period. Journal of the American Academy of Child and Adolescent Psychiatry, 31(4), 679–685.CrossRefPubMed

Pottick, K., Hansell, S., Gaboda, D., & Gutterman, E. (1993). Child and adolescent outcomes of inpatient psychiatric services: A research agenda. Children and Youth Services Review, 15(5), 371–384.CrossRef

Pottick, K. J., Hansell, S., Miller, J. E., & Davis, D. M. (1999). Youths living away from families in the U.S. Mental health system: Opportunities for targeted intervention. The Journal of Behavioral Health Services & Research, 32(3), 264–281.CrossRef

Romansky, J. B., Lyons, J. S., Lehner, R. K., & West, C. M. (2003). Factors related to psychiatric hospital readmission among children and adolescents in state custody. Psychiatric Services, 54, 356–362.CrossRefPubMed

Saunders, R. C., & Heflinger, C. A. (2003). Access to and patterns of use of behavioral health services among children and adolescents in TennCare. Psychiatric Services, 54(10), 1364–1371.CrossRefPubMed

Segal, H. G., King, C. A., & Naylor, M. W. (1995). Psychosocial functioning of severely disturbed adolescents after short-term hospitalization. Psychiatric Services, 46(3), 287–289.PubMed

Sharfstein, S. S. (2009). Goals of inpatient treatment for psychiatric disorders. Annual Review of Medicine, 60, 393–403.CrossRefPubMed

Silverman, W. K., & Hinshaw, S. P. (2008). The second Special Issue on evidence-based psycho-social treatments for children and adolescents: A 10-year update. Journal of Clinical Child & Adolescent Psychology, 37(1), 1–7.CrossRef

Singer, J. D., & Willett, J. B. (2003). Applied longitudinal data analysis: Modeling change and event occurrence. New York: Oxford University Press.

Solomon, P., Evans, D., & Delaney, M. A. (1993). Community service utilization by youths hospitalized in a state psychiatric facility. Community Mental Health Journal, 29, 333–346.CrossRefPubMed

Stroul, B., & Friedman, R. (1986). A system of care for children and youth with severe emotional disturbances. Washington, DC: Georgetown University Child Development Center, National Technical Assistance Center for Children’s Mental Health.

U.S. Department of Health and Human Services (1996). Health information privacy. Retrieved 09/11/09 from http://www.hhs.gov/ocr/privacy/.

Warner, L. A., Pottick, K. J., & Bilder, S. M. (2005). Clinical and organizational correlates of medication for youths in U.S. Mental Health Services. Social Service Review, 79(3), 454–481.CrossRef

Wickizer, T. M., Lessler, D., & Wickizer, J. B. (1999). Effects of health care cost-containment programs on patterns of care and readmissions among children and adolescents. American Journal of Public Health, 89(9), 1353–1358.CrossRefPubMed

Titel: Post-Discharge Services and Psychiatric Rehospitalization Among Children and Youth
verfasst von: Sigrid James
Sherma J. Charlemagne
Amanda B. Gilman
Qais Alemi
Rhoda L. Smith
Priya R. Tharayil
Kimberly Freeman
Publikationsdatum: 01.09.2010
Verlag: Springer US
Erschienen in: Administration and Policy in Mental Health and Mental Health Services Research / Ausgabe 5/2010
Print ISSN: 0894-587X
Elektronische ISSN: 1573-3289
DOI: https://doi.org/10.1007/s10488-009-0263-6

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Post-Discharge Services and Psychiatric Rehospitalization Among Children and Youth

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