Abstract
This study examined the extent to which facility characteristics, discharge practices, and the availability of outpatient mental health care are associated with receiving follow-up care within 7 days of discharge from an inpatient psychiatric facility among Medicare beneficiaries. The study merged 2018 National Mental Health Services Survey data with 2018 Inpatient Psychiatric Facility Quality Reporting program data representing 1147 inpatient psychiatric facilities. Results from logistic regression analyses indicated that inpatient facilities operated by private for-profit organizations and public agencies had lower odds of achieving high performance on a measure that assessed if Medicare beneficiaries received follow-up care within 7 days of discharge relative to private nonprofit facilities; follow-up rates were inversely associated with the proportion of involuntarily committed patients at the facility. Follow-up rates were not associated with other facility characteristics, discharge practices, the availability of outpatient care at the location of the inpatient facility, or the density of outpatient mental health providers in the community. Improving follow-up care for Medicare beneficiaries could target for-profit and public hospitals and those that serve a high proportion of individuals involuntarily committed to inpatient care.
This is a preview of subscription content, access via your institution.
Change history
12 August 2022
A Correction to this paper has been published: https://doi.org/10.1007/s11414-022-09816-1
References
Mark TL, Tomic KS, Kowlessar N, et al. Hospital readmission among Medicaid patients with an index hospitalization for mental and/or substance use disorder. Journal of Behavioral Health Services & Research 2013; 40:207-221.
Olfson M, Marcus SC, Doshi JA. Continuity of care after inpatient discharge of patients with schizophrenia in the Medicaid program: A retrospective longitudinal cohort analysis. Journal of Clinical Psychiatry 2010; 71:831-838.
Stein BD, Kogan JN, Sorbero MJ, et al. Predictors of timely follow-up care among Medicaid-enrolled adults after psychiatric hospitalization. Psychiatric Services 2007; 58:1563-1569.
Cook BL, Trinh NH, Li Z, et al. Trends in racial-ethnic disparities in access to mental health care, 2004-2012. Psychiatric Services 2017; 68:9-16.
Cook BL, Doksum T, Chen CN, et al. The role of provider supply and organization in reducing racial/ethnic disparities in mental health care in the U.S. Social Science & Medicine 2013; 84:102–109.
Smith TE, Abraham M, Bolotnikova NV, et al. Psychiatric inpatient discharge planning practices and attendance at aftercare appointments. Psychiatric Services 2017; 68:92-95.
Benjenk I, Chen J. Variation of follow-up rate after psychiatric hospitalization of Medicare beneficiaries by hospital characteristics and social determinants of health. American Journal of Geriatric Psychiatry 2019; 27:138-148.
Cummings JR, Allen L, Clennon J, et al. Geographic access to specialty mental health care across high- and low-income US communities. JAMA Psychiatry 2017; 74:476-484.
Center for Behavioral Health Statistics and Quality. National Mental Health Services Survey (N-MHSS), 2018 . Rockville, MD: Substance Abuse and Mental Health Services Administration, 2018.
QualityNet. Inpatient Psychiatric Facility Quality Reporting (IPFQR) Program Measures. n.d. Available online at https://www.qualitynet.org/ipf/ipfqr/measures. Accessed November 4, 2020.
QualityNet. Inpatient Psychiatric Facility Quality Reporting Program Claims-Based Measure Specifications. Baltimore, MD: Centers for Medicare & Medicaid Services, 2020. Available at https://www.qualitynet.org/files/5eda97b96c4799002344a100?filename=FY21_IPFQR_CBM_Specs.pdf.
Physician Consortium for Performance Improvement Foundation. Care Transitions Performance Measurement Set: Inpatient Discharges & Emergency Department Discharges. Chicago, IL, Physician Consortium for Performance Improvement Foundation, 2016.
Park S, Hamadi H, Apatu E, et al. Hospital partnerships in population health initiatives. Population Health Management 2020; 23:226-233.
George Washington University School of Business. For Profit vs. Nonprofit Hospital Administration. November 5, 2020. Blog. Available at https://healthcaremba.gwu.edu/blog/profit-vs-nonprofit-hospital-administration/.
Dixon L, Goldberg R, Iannone V, et al. Use of a critical time intervention to promote continuity of care after psychiatric inpatient hospitalization. Psychiatric Services 2009; 60:451-458.
Greene JA, Bina R, Gum AM. Interventions to increase retention in mental health services: A systematic review. Psychiatric Services 2016; 67:485-495.
Smith TE, Haselden M, Corbeil T, et al. Factors associated with discharge planning practices for patients receiving inpatient psychiatric care. Psychiatric Services 2021; 72:498-506.
Haselden M, Corbeil T, Tang F, et al. Family involvement in psychiatric hospitalizations: Associations with discharge planning and prompt follow-up care. Psychiatric Services 2019; 70:860-866.
Medicaid.gov. Annual Reporting on the Quality of Care for Adults in Medicaid (FFY 2018). 2019. Available at https://www.medicaid.gov/medicaid/quality-of-care/performance-measurement/adult-and-child-health-care-quality-measures/adult-core-set/index.html.
Acknowledgements
We appreciate the feedback of Herman Alvarado (SAMHSA) and Linda Hermer (Eagle Technologies) on previous drafts. Ian Huff and Christine Cheu (Mathematica) provided programming support.
Funding
The Substance Abuse and Mental Health Services Administration (contract HHSS283201600001C/LC-001-BHSIS) sponsored this study.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of Interest
The authors declare no competing interests.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
The original online version of this article was revised: In the online publication, the first sentence in the Results section incorrectly reads:
Across IPFs, 28% of Medicare beneficiaries received follow-up care within 7 days of discharge had their records transmitted to the next provider within 24 h of discharge based on the Timely Transmission of Transition Record measure (median = 68%; range 0 to 100% across IPFs). Should be replaced with: Across IPFs, 28% of Medicare beneficiaries discharged from an IPF received follow-up care within 7 days (median = 26%; range 0 to 81% across IPFs) and 50% of those discharged had their records transmitted to the next provider within 24 hours of discharge based on the Timely Transmission of Transition Record measure (median = 68%; range 0 to 100% across IPFs).
Rights and permissions
About this article
Cite this article
Brown, J.D., Bell, N. Factors Associated with the Receipt of Follow-Up Care Among Medicare Beneficiaries Discharged from Inpatient Psychiatric Facilities. J Behav Health Serv Res 50, 221–227 (2023). https://doi.org/10.1007/s11414-022-09810-7
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11414-022-09810-7