Predicting rehospitalization and outpatient services from administration and clinical databases
Purchase on Springer.com
$39.95 / €34.95 / £29.95*
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.
The study tests whether psychiatric services utilization may be predicted from administrative databases without clinical variables equally as well as from databases with clinical variables. Persons with a psychiatric hospitalization at an urban medical center were followed for 1 year postdischarge (N=1384.) Dependent variables included statewide rehospitalization and the number of hours of outpatient services received. Three linear and logistic regression models were developed and cross-validated: a basic model with limited administrative independent variables, an intermediate model with diagnostic and limited clinical indicators, and a full model containing additional clinical predictors. For rehospitalization, the clinical cross-validated model accounted for twice the variance accounted by the basic model (adjusted R2=.13 and .06, respectively). For outpatient hours, the basic cross-validated model performed as well as the clinical model (adjusted R2=.36 and .34, respectively.) Clinical indicators such as assessment of functioning and co-occurring substance use disorder should be considered for inclusion in predicting rehospitalization.
- Mazade MA, Lutterman T, Glover R. State mental health agency performance measure initiatives in the public mental health system. Center for Mental Health Services. In: Mandersheid RW, Henderson MJ, eds.Mental Health, United States, 1998. Washington, DC: Supt. of Docs., US Government Printing Office; 1998:52–59. DHHS Publication No. (SMA)99-3285.
- Teague GB, Ganju V, Hornik JA, et al. The MHSIP mental health report card.Evaluation Review. 1997;21:330–341.
- Banks SM, Pandiani JA, Schacht L, et al. A risk-adjusted measure of hospitalization rates for evaluating community mental health program performance.Administration and Policy in Mental Health. 1999;26:269–279.
- Hornbrook MC, Goodman MJ. Assessing relative health plan risk with the RAND-36 health survey.Inquiry. 1995;32:56–74.
- Fowles JB, Weiner JP, Knutson D, et al. Taking health status into account when setting capitation rates.JAMA. 1996;276:1316–1321.
- Lee C, Rogal D.Risk Adjustment: A Key to Changing Incentives in the Health Insurance Market. Alpha Center; Washington DC March 1997.
- Weiner JP, Dobson A, Maxwell SL, et al. Risk-adjusted Medicare capitation rates using ambulatory and inpatient diagnoses.Health Care Financing Review. 1996;17(3):77–99.
- Newhouse JP, Manning WG, Keeler EB, et al. Adjusting capitation rates using objective health measures and prior utilization.Health Care Financing Review. 1989;10:41–54.
- Ettner SL, Frank RG.Risk Adjustment for Mental Health and Substance Abuse. Center for Mental Health Service, Substance Abuse and Mental Health Services Administration; Washington DC January 1999.
- Kapur K, Young AS, Murata D. Risk adjustment for high utilizers of public mental health care.The Journal of Mental Health Policy and Economics. 2000;3:129–137.
- Vogel S, Huguelet P. Factors associated with multiple admissions to a public psychiatric hospital.Acta Psychiatrica Scandinavica. 1997;95:244–253.
- Doering S, Muller E, Kopcke W, et al. Predictors of relapse and rehospitalization in schizophrenia and schizoaffective disorder.Schizophrenia Bulletin. 1998;24:87–98.
- Mercer GT, Molinari V, Kunik ME, et al. Rehospitalization of older psychiatric inpatients: an investigation of predictors.Gerontologist. 1999;39:591–598.
- Olfson M, Mechanic D, Boyer CA, et al. Assessing clinical predictions of early rehospitalization in schizophrenia.Journal of Nervous and Mental Disease. 1999;187:721–729.
- Perlick DA, Rosenheck RA, Clarkin JF, et al. Symptoms predicting inpatient service use among patients with bipolar affective disorder.Psychiatric Services. 1999;50:806–812.
- Rabinowitz J, Lichtenberg P, Kaplan Z, et al. Rehospitalization rates of chronically ill schizophrenic patients discharged on a regimen of risperadone, olanzapine, or conventional antipsychotics.American Journal of Psychiatry. 2001;158:266–269.
- Russo J, Roy-Byrne P, Jaffe C, et al. Psychiatric status, quality of life, and levels of care as predictors of outcomes of acute inpatient treatment.Psychiatric Services. 1997;48:1427–1434.
- Hollingsworth EJ, Sweeney JK. Mental health expenditures for services for people with severe mental illnesses.Psychiatric Services. 1997;48:485–490.
- Larson MJ, Farrelly MC, Hodgkin D, et al. Payments and use of services for mental health, alcohol, and other drug abuse disorders: estimates from Medicare, Medicaid, and Private Health Plans. Center for Mental Health Services. In: Mandersheid RW, Henderson MJ, eds.Mental Health, United States, 1998. Washington, DC: Supt. of Docs., US Government Printing Office; 1998:124–141. DHHS Publication No. (SMA)99-3285.
- Predicting rehospitalization and outpatient services from administration and clinical databases
The Journal of Behavioral Health Services & Research
Volume 30, Issue 3 , pp 342-351
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- Author Affiliations
- 1. Washington Institute for Mental Illness Research and Training, Washington State University, 310 N. Riverpoint Blvd., P. O. Box 1495, 99210, Spokane, WA
- 2. Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle
- 3. Outcomes Assessment and Quality Assurance, Harborview Medical Center, Seattle, Washington
- 4. Mental Health Division in Department of Social and Health Services, Olympia, Washington
- 5. Outpatient Psychiatry and Addiction Services, Harborview Medical Center, Seattle, Washington