Coordinated Behavioral Care, 55 Broadway, Suite 701, New York, NY, 10006, USA.
New York State Office of Mental Health, Bureau of Evidence Based Services and Implementation Science, 330 Fifth Avenue-9th Floor, New York, NY, 10001, USA.
Community Ment Health J. 2022 Apr;58(3):415-419. doi: 10.1007/s10597-021-00902-w. Epub 2021 Oct 16.
This study examined the impact of Pathway Home™ (PH) transition services for high utilizers of psychiatric hospitalization on inpatient days and outpatient engagement post-hospital discharge.
This case series study of forty PH graduates (5/22/2015-8/31/2018) used Medicaid claims to assess psychiatric inpatient days-per-month, average proportion of months with psychiatric emergency room, outpatient, and health home care management services. T-tests compared three time periods: the year prior, during, and after enrollment.
Graduates had significantly fewer psychiatric inpatient days/month during (M = 1.84, p < 0.001) and after PH enrollment (M = 1.88, p < 0.001) compared to prior to enrollment (M = 7.1), while emergency services were stable. Outpatient visits increased from 45% prior to 76% during enrollment (p < 0.001) and was sustained on follow-up (67%, p = 0.008). A similar pattern emerged for health home services (32%, 60%, and 50%).
PH is a promising approach for improving outcomes for high utilizers of psychiatric inpatient services, with sustained impact on follow-up.
本研究考察了“归家之路”（Pathway Home，PH）过渡服务对精神科住院高使用者的住院天数和出院后门诊参与度的影响。
本病例系列研究纳入了 40 名 PH 毕业生（2015 年 5 月 22 日至 2018 年 8 月 31 日），使用医疗补助（Medicaid）索赔数据评估其每月的精神科住院天数、每月精神科急诊就诊比例、门诊和家庭健康管理服务的平均比例。采用 t 检验比较了三个时间段：入组前一年、入组期间和入组后。
与入组前相比（M=7.1），毕业生在入组期间（M=1.84，p<0.001）和入组后（M=1.88，p<0.001）的精神科住院天数明显减少，而急诊服务保持稳定。门诊就诊率从入组前的 45%增加到入组期间的 76%（p<0.001），并在随访期间保持（67%，p=0.008）。家庭健康服务也出现了类似的模式（32%、60%和 50%）。
PH 是改善精神科住院高使用者结局的一种很有前途的方法，对后续影响具有可持续性。
