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Factors Associated With 7-Day Follow-Up Outpatient Mental Healthcare in Older Adults Hospitalized for Suicidal Ideation, Suicide Attempt, and Self-Harm

•What is the primary question addressed by this study?This national study examined patient, hospital, and regional factors associated with 7-day follow-up outpatient mental healthcare after hospitalization for suicidal ideation, suicide attempt, and deliberate self-harm.•What is the main finding of... Full description

Journal Title: The American journal of geriatric psychiatry 2022-04, Vol.30 (4), p.478-491
Main Author: Schmutte, Timothy
Other Authors: Olfson, Mark , Xie, Ming , Marcus, Steven C
Format: Electronic Article Electronic Article
Language: English
Subjects:
Quelle: Alma/SFX Local Collection
Publisher: England: Elsevier Inc
ID: ISSN: 1064-7481
Link: https://www.ncbi.nlm.nih.gov/pubmed/34563430
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title: Factors Associated With 7-Day Follow-Up Outpatient Mental Healthcare in Older Adults Hospitalized for Suicidal Ideation, Suicide Attempt, and Self-Harm
format: Article
creator:
  • Schmutte, Timothy
  • Olfson, Mark
  • Xie, Ming
  • Marcus, Steven C
subjects:
  • Aged
  • Female
  • follow-up care
  • Follow-Up Studies
  • Hospitalization
  • Humans
  • Medicare
  • Mental health care
  • Mental Health Services
  • older adults
  • Older people
  • Outpatients
  • Retrospective Studies
  • Self destructive behavior
  • self-harm
  • Self-Injurious Behavior - epidemiology
  • Self-Injurious Behavior - psychology
  • Self-Injurious Behavior - therapy
  • Suicidal Ideation
  • Suicide
  • Suicide, Attempted
  • Suicides & suicide attempts
  • United States - epidemiology
ispartof: The American journal of geriatric psychiatry, 2022-04, Vol.30 (4), p.478-491
description: •What is the primary question addressed by this study?This national study examined patient, hospital, and regional factors associated with 7-day follow-up outpatient mental healthcare after hospitalization for suicidal ideation, suicide attempt, and deliberate self-harm.•What is the main finding of this study?Large differences in follow-up rates were observed for patients with any recent mental healthcare (43.7%) compared to patients with no recent mental healthcare (15.7%). Whereas length of stay and care in psychiatric hospitals were associated with higher odds of follow-up, among patients with no recent mental healthcare discharge from hospitals that were large, system-affiliated, academic medical centers, or provided hospitalist-based care were associated with lower odds of follow-up.•What is the meaning of the finding?Timely follow-up is influenced by multiple patient, hospital, and community characteristics. Older adults are one of the fastest growing age groups seeking emergency care for suicidal ideation and self-harm. Timely follow-up outpatient mental healthcare is important to suicide prevention, yet little is known about predictors of care continuity following hospital discharge. This study identified patient-, hospital-, and regional-level factors associated with 7-day follow-up outpatient mental healthcare in suicidal older adults. Retrospective cohort analysis using 2015 Medicare data for adults aged ≥65 years hospitalized for suicidal ideation, suicide attempt, or deliberate self-harm (n = 27,257) linked with the American Hospital Association survey and Area Health Resource File. Rates and adjusted risk ratios stratified by patient, hospital, and regional variables were assessed for 7-day follow-up outpatient mental healthcare. Overall, 30.3% of patients received follow-up mental healthcare within 7 days of discharge. However, follow-up rates were higher for patients with any mental healthcare within 30 days prehospitalization (43.7%) compared to patients with no recent mental healthcare (15.7%). Longer length of stay and care in psychiatric hospitals were associated with higher odds of follow-up. For patients with no mental healthcare in the 30 days prehospitalization, discharge from hospitals that were large, system-affiliated, academic medical centers, or provided hospitalist-based care were associated with lower odds of follow-up. Females were more likely to receive 7-day follow-up, whereas non-white patients were less likely to receive
language: eng
source: Alma/SFX Local Collection
identifier: ISSN: 1064-7481
fulltext: fulltext
issn:
  • 1064-7481
  • 1545-7214
url: Link


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titleFactors Associated With 7-Day Follow-Up Outpatient Mental Healthcare in Older Adults Hospitalized for Suicidal Ideation, Suicide Attempt, and Self-Harm
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creatorSchmutte, Timothy ; Olfson, Mark ; Xie, Ming ; Marcus, Steven C
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description•What is the primary question addressed by this study?This national study examined patient, hospital, and regional factors associated with 7-day follow-up outpatient mental healthcare after hospitalization for suicidal ideation, suicide attempt, and deliberate self-harm.•What is the main finding of this study?Large differences in follow-up rates were observed for patients with any recent mental healthcare (43.7%) compared to patients with no recent mental healthcare (15.7%). Whereas length of stay and care in psychiatric hospitals were associated with higher odds of follow-up, among patients with no recent mental healthcare discharge from hospitals that were large, system-affiliated, academic medical centers, or provided hospitalist-based care were associated with lower odds of follow-up.•What is the meaning of the finding?Timely follow-up is influenced by multiple patient, hospital, and community characteristics. Older adults are one of the fastest growing age groups seeking emergency care for suicidal ideation and self-harm. Timely follow-up outpatient mental healthcare is important to suicide prevention, yet little is known about predictors of care continuity following hospital discharge. This study identified patient-, hospital-, and regional-level factors associated with 7-day follow-up outpatient mental healthcare in suicidal older adults. Retrospective cohort analysis using 2015 Medicare data for adults aged ≥65 years hospitalized for suicidal ideation, suicide attempt, or deliberate self-harm (n = 27,257) linked with the American Hospital Association survey and Area Health Resource File. Rates and adjusted risk ratios stratified by patient, hospital, and regional variables were assessed for 7-day follow-up outpatient mental healthcare. Overall, 30.3% of patients received follow-up mental healthcare within 7 days of discharge. However, follow-up rates were higher for patients with any mental healthcare within 30 days prehospitalization (43.7%) compared to patients with no recent mental healthcare (15.7%). Longer length of stay and care in psychiatric hospitals were associated with higher odds of follow-up. For patients with no mental healthcare in the 30 days prehospitalization, discharge from hospitals that were large, system-affiliated, academic medical centers, or provided hospitalist-based care were associated with lower odds of follow-up. Females were more likely to receive 7-day follow-up, whereas non-white patients were less likely to receive follow-up care. Timely follow-up is influenced by multiple patient, hospital, and community characteristics. Findings highlight the need for quality improvement to promote successful transitions from inpatient to outpatient care.
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subjectAged ; Female ; follow-up care ; Follow-Up Studies ; Hospitalization ; Humans ; Medicare ; Mental health care ; Mental Health Services ; older adults ; Older people ; Outpatients ; Retrospective Studies ; Self destructive behavior ; self-harm ; Self-Injurious Behavior - epidemiology ; Self-Injurious Behavior - psychology ; Self-Injurious Behavior - therapy ; Suicidal Ideation ; Suicide ; Suicide, Attempted ; Suicides & suicide attempts ; United States - epidemiology
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1Copyright © 2021 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.
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abstract•What is the primary question addressed by this study?This national study examined patient, hospital, and regional factors associated with 7-day follow-up outpatient mental healthcare after hospitalization for suicidal ideation, suicide attempt, and deliberate self-harm.•What is the main finding of this study?Large differences in follow-up rates were observed for patients with any recent mental healthcare (43.7%) compared to patients with no recent mental healthcare (15.7%). Whereas length of stay and care in psychiatric hospitals were associated with higher odds of follow-up, among patients with no recent mental healthcare discharge from hospitals that were large, system-affiliated, academic medical centers, or provided hospitalist-based care were associated with lower odds of follow-up.•What is the meaning of the finding?Timely follow-up is influenced by multiple patient, hospital, and community characteristics. Older adults are one of the fastest growing age groups seeking emergency care for suicidal ideation and self-harm. Timely follow-up outpatient mental healthcare is important to suicide prevention, yet little is known about predictors of care continuity following hospital discharge. This study identified patient-, hospital-, and regional-level factors associated with 7-day follow-up outpatient mental healthcare in suicidal older adults. Retrospective cohort analysis using 2015 Medicare data for adults aged ≥65 years hospitalized for suicidal ideation, suicide attempt, or deliberate self-harm (n = 27,257) linked with the American Hospital Association survey and Area Health Resource File. Rates and adjusted risk ratios stratified by patient, hospital, and regional variables were assessed for 7-day follow-up outpatient mental healthcare. Overall, 30.3% of patients received follow-up mental healthcare within 7 days of discharge. However, follow-up rates were higher for patients with any mental healthcare within 30 days prehospitalization (43.7%) compared to patients with no recent mental healthcare (15.7%). Longer length of stay and care in psychiatric hospitals were associated with higher odds of follow-up. For patients with no mental healthcare in the 30 days prehospitalization, discharge from hospitals that were large, system-affiliated, academic medical centers, or provided hospitalist-based care were associated with lower odds of follow-up. Females were more likely to receive 7-day follow-up, whereas non-white patients were less likely to receive follow-up care. Timely follow-up is influenced by multiple patient, hospital, and community characteristics. Findings highlight the need for quality improvement to promote successful transitions from inpatient to outpatient care.
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