Intervention to Reduce Inpatient Psychiatric Admission in a Metropolitan City
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When psychiatric hospitalization is over-used, it represents a financial drain and failure of care. We evaluated implementation and cessation of transporting people medically certified for psychiatric hospitalization to a central psychiatric emergency service for management and re-evaluation of hospitalization need. After implementation, the hospitalization rate declined 89 % for 346 transported patients; only four of the nonhospitalized patients presented in crisis again in the next 30 days. Following cessation, the hospitalization rate jumped 59 % compared to the preceding year. Costs declined 78.7 % per diverted patient. The findings indicate that it is possible to reduce hospitalization and costs, and maintain quality care.
KeywordsPsychiatric hospitalization Psychiatric emergency services Quality improvement Hospitalization diversion Public mental health
Conflict of interest
This study was funded in part by the Lyckai-Young funds from the State of Michigan, Detroit Wayne Mental Health Authority, and Gateway Community Health.
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