Factors Associated With 7-Day Follow-Up Outpatient Mental Healthcare in Older Adults Hospitalized for Suicidal Ideation, Suicide Attempt, and Self-Harm
| Autor: | Steven C. Marcus, Ming Xie, Mark Olfson, Timothy Schmutte |
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| Rok vydání: | 2022 |
| Předmět: |
Mental Health Services
medicine.medical_specialty Suicide Attempted Medicare Suicide prevention Suicidal Ideation Odds Ambulatory care Outpatients medicine Humans Suicidal ideation Aged Retrospective Studies Suicide attempt business.industry Retrospective cohort study United States Identified patient Psychiatry and Mental health Relative risk Family medicine Female Geriatrics and Gerontology medicine.symptom business Self-Injurious Behavior Follow-Up Studies |
| Zdroj: | The American Journal of Geriatric Psychiatry. 30:478-491 |
| ISSN: | 1064-7481 |
| Popis: | Objective Older adults are one of the fastest growing age groups seeking emergency care for suicidal ideation and self-harm. Timely follow-up outpatient mental healthcare is important to suicide prevention, yet little is known about predictors of care continuity following hospital discharge. This study identified patient-, hospital-, and regional-level factors associated with 7-day follow-up outpatient mental healthcare in suicidal older adults. Methods Retrospective cohort analysis using 2015 Medicare data for adults aged ≥65 years hospitalized for suicidal ideation, suicide attempt, or deliberate self-harm (n = 27,257) linked with the American Hospital Association survey and Area Health Resource File. Rates and adjusted risk ratios stratified by patient, hospital, and regional variables were assessed for 7-day follow-up outpatient mental healthcare. Results Overall, 30.3% of patients received follow-up mental healthcare within 7 days of discharge. However, follow-up rates were higher for patients with any mental healthcare within 30 days prehospitalization (43.7%) compared to patients with no recent mental healthcare (15.7%). Longer length of stay and care in psychiatric hospitals were associated with higher odds of follow-up. For patients with no mental healthcare in the 30 days prehospitalization, discharge from hospitals that were large, system-affiliated, academic medical centers, or provided hospitalist-based care were associated with lower odds of follow-up. Females were more likely to receive 7-day follow-up, whereas non-white patients were less likely to receive follow-up care. Conclusion Timely follow-up is influenced by multiple patient, hospital, and community characteristics. Findings highlight the need for quality improvement to promote successful transitions from inpatient to outpatient care. |
| Databáze: | OpenAIRE |
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