Selective criteria for transfer to community hospital inpatient mental health services

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To reduce census and downsize operations, state inpatient care is being relocated to community hospitals. Planners must consider current selection processes to effect system redesign. This research examined a collaborative admission process from a state provider to community hospitals. Consumers with involved family/significant others were likely to be transferred. Those exhibiting suicidal behavior and males with assaultive behavior were unlikely to be transferred. It is suggested that cross sector specialization is a practical strategy for redesign and that community hospitals may require enhancements to function as sole core providers for the SMI population.

Preparation of this article was supported in part by grant #MH16242 NIMH, Rutgers Center for Research on the Organization and Financing of Care for the Severely Mentally Ill. The author is grateful to David Mechanic, Lucy Sarkis, Mark Olfson, and Harvey Lieberman for comments on previous drafts; and to Robert DiGiovanni, Charles Capella, the South Beach Psychiatric Center Team Leaders and Department of Medical Records for assistance in data collection.