Deaths among former psychiatric inpatients in an outreach case management program.
OBJECTIVE
The mortality rate of discharged psychiatric inpatients has long been known to be higher than that of persons in the general population. This study assessed the effectiveness of outreach case management in reducing the mortality rate of recently discharged psychiatric inpatients in New York City.


METHODS
A sample of 292 patients discharged from an inpatient psychiatry service at an urban general hospital were randomly assigned either to an intervention group (N = 147), which received intensive outreach case management for periods ranging from 15 to 52 months after discharge, or to a control group (N = 145), which received standard aftercare services. Both groups were offered and received regular aftercare and other services during the study period. Both groups were followed for comparable periods of time to determine their rate of mortality.


RESULTS
The overall mortality rate for the total group of 292 patients was 7.2 percent, 2.25 times higher than among persons in the general population matched for age, sex, and race. The mortality rates for the intervention group and the control group were 7.5 percent and 6.9 percent, respectively, not a significant difference.


CONCLUSIONS
Discharged psychiatric inpatients who received outreach case management did not have a lower mortality rate than similar patients who did not receive this intervention.
Curtis
J L
JL
Department of Psychiatry, Harlem Hospital Center, New York City 10037, USA.
Millman
E J
EJ
Struening
E
E
D'Ercole
A
A
D000328:Adult; D000359:Aftercare / Q000706:statistics & numerical data; D019090:Case Management / Q000706:statistics & numerical data*; D003191:Comprehensive Health Care / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006786:Hospitals, Urban; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000401:mortality* / Q000523:psychology / Q000534:rehabilitation; D008875:Middle Aged; D009519:New York City / Q000453:epidemiology; D010351:Patient Discharge / Q000706:statistics & numerical data*; D010359:Patient Readmission / Q000706:statistics & numerical data; D011567:Psychiatric Department, Hospital; D012017:Referral and Consultation / Q000706:statistics & numerical data; D016019:Survival Analysis; D016896:Treatment Outcome; D014505:Urban Population / Q000706:statistics & numerical data*