title: Colocated general medical care and preventable hospital admissions for veterans with serious mental illness.
abstract: OBJECTIVE
  This study examined whether veterans with serious mental illness in mental health settings with colocated general medical care had fewer hospitalizations for ambulatory care-sensitive conditions than veterans in other settings.
  
  
  METHODS
  Using 2007 data, the study examined hospitalizations for ambulatory care-sensitive conditions with zero-inflated negative binomial regression controlling for demographic, clinical, and facility characteristics.
  
  
  RESULTS
  Of 92,268 veterans with serious mental illness, 9,662 (10.5%) received care at ten sites with colocated care and 82,604 (89.5%) at 98 sites without it. At sites without colocation, 5.1% had a hospitalization for an ambulatory care-sensitive condition, compared with 4.3% at sites with colocation. Attendance at sites with colocated care was associated with an adjusted count of hospitalizations of .76 compared with attendance at sites with no colocation (β=-.28, 95% confidence interval=.47 to -.09, p=.004).
  
  
  CONCLUSIONS
  Colocation of general medical services in the mental health setting was associated with significantly fewer preventable hospitalizations.
authors.affiliation: Providence Department of VeteransAffairs (VA) Medical Center, Providence, RI02908-4799, USA. paul.pirraglia@va.gov
authors.forename: Paul A
authors.initials: PA
authors.lastname: Pirraglia
authors.forename: Amy M
authors.initials: AM
authors.lastname: Kilbourne
authors.forename: Zongshan
authors.initials: Z
authors.lastname: Lai
authors.forename: Peter D
authors.initials: PD
authors.lastname: Friedmann
authors.forename: Thomas P
authors.initials: TP
authors.lastname: O'Toole
mesh_terms: D000553:Ambulatory Care; D016001:Confidence Intervals; D019538:Health Care Surveys; D006297:Health Services Accessibility; D006760:Hospitalization; D006801:Humans; D008297:Male; D001523:Mental Disorders; D012044:Regression Analysis; D012720:Severity of Illness Index; D014481:United States; D014728:Veterans / Q000523:psychology*