title: Follow-up after inpatient psychiatric hospitalization with partial control of the system responsiveness variable.
abstract: One of the most significant predictors of prompt rehospitalization following psychiatric hospital discharge is missing follow-up out-patient appointments. Previous studies have suggested that system responsiveness accounted for much of the variance in predicting compliance with aftercare. Collaborations established at our institution allowed us to partially control this variable, opening the way to explore other obstacles to aftercare. All severely mentally ill subjects discharged from our hospital are provided follow-up appointments within two weeks. We retrospectively evaluated compliance with aftercare appointment and investigated factors that were associated with compliance. Eighty-one subjects were evaluated. Twenty-seven (33.8 %) did not attend their first follow-up appointment. Subjects with a primary substance-related syndrome were the most likely to miss their appointment (83.3%, chi 2 = 17.02, p = .0045), as were uninsured patients (51.6%, chi 2 = 8.79, p = .003). There was a trend for individuals not previously involved with their aftercare providers to miss their appointment (48.9%, chi 2 = 3.35, p = .067). Despite partial control of the system responsiveness variable, compliance with aftercare was suboptimal. This was due to a combination of client vulnerability variables and uncontrollable system responsiveness factors.
authors.affiliation: Mood Disorders Research Program, Department of Psychiatry and Behavioral Sciences, University of Louisville School of Medicine, Louisville, Kentucky 40291, USA. rselma01@louisville.edu
authors.forename: Rif S
authors.initials: RS
authors.lastname: El-Mallakh
authors.forename: Tina
authors.initials: T
authors.lastname: James
authors.forename: Tehmina
authors.initials: T
authors.lastname: Khan
authors.forename: Marina
authors.initials: M
authors.lastname: Katz
authors.forename: Bethany
authors.initials: B
authors.lastname: McGovern
authors.forename: Sunil
authors.initials: S
authors.lastname: Nair
authors.forename: Scott
authors.initials: S
authors.lastname: Tallent
authors.forename: Gregory
authors.initials: G
authors.lastname: Williams
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis* / Q000523:psychology / Q000534:rehabilitation*; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010349:Patient Compliance / Q000706:statistics & numerical data