Long-term efficacy of a continuity-of-care treatment model for patients with severe mental illness who transition from in-patient to out-patient services.
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Abstract
Background: Despite its significance, ensuring continuity of care demands substantial resources, which might not be readily accessible in many public healthcare systems. Studies indicate that continuity of care remains uncertain in numerous healthcare systems.
Aims: This study aimed to assess the effectiveness of a continuity-of-care model for patients with severe mental illness (SMI), providing seamless treatment from discharge from a closed ward to subsequent psychiatric, psychological and rehabilitation services.
Method: Data from patients discharged before (1 January to 31 December 2018) and after (1 June 2021 to 31 May 2022) full implementation of the model were analysed and compared in terms of average duration of hospital stay, emergency department visits within 90 days of discharge, readmission rate within a year post-discharge and initiation of rehabilitation process.
Results: In the post-implementation period (n = 482), the average admission time significantly decreased from 30.51 ± 29.72 to 26.77 ± 27.89 days, compared with the pre-implementation period (n = 403) (P = 0.029). Emergency department visits within 90 days following discharge decreased from 38.70 to 26.35% of discharged patients (P < 0.001). The rate of readmission decreased from 50.9 to 44.0% (P = 0.041) for one readmission and from 28.3 to 22.0% (P = 0.032) for two readmissions in the year following discharge. Additionally, the proportion of patients entering formal rehabilitation increased from 7.94 to 12.03% (P = 0.044).
Conclusions: This study highlights the effectiveness of a continuity-of-care model spearheaded by senior psychiatrists and involving paramedical personnel. These findings underscore the significant potential of the model to substantially enhance mental health services and outcomes. Moreover, they emphasise its relevance for patients, clinicians and policy makers.
期刊介绍：
The British Journal of Psychiatry (BJPsych) is a renowned international journal that undergoes rigorous peer review. It covers various branches of psychiatry, with a specific focus on the clinical aspects of each topic. Published monthly by the Royal College of Psychiatrists, this journal is dedicated to enhancing the prevention, investigation, diagnosis, treatment, and care of mental illness worldwide. It also strives to promote global mental health. In addition to featuring authoritative original research articles from across the globe, the journal includes editorials, review articles, commentaries on contentious issues, a comprehensive book review section, and a dynamic correspondence column. BJPsych is an essential source of information for psychiatrists, clinical psychologists, and other professionals interested in mental health.
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