A program to improve aftercare in a rural area.

A pilot project for improving aftercare in a rural area places the responsibility of aftercare on the project staff rather than on the hospital staff or referral agency personnel. Three counselors cover 31 counties in the catchment area. They contact patients before discharge and again within one month after discharge. When the patient is receiving the desired aftercare, the counselor steps aside, but maintains contact with the referral agency and is available to help the patient when necessary. A study of 23 patients after the first year of the program showed that the average number of days each spent in the hospital during one year dropped from 159 to 49, and the average yearly cost of hospitalization per patient decreased from 8614 dollars to 3384 dollars. Two brief case examples show that the program also has enhanced the quality of life for many of the discharged patients.