title: Postdischarge care for depression in Ontario.
abstract: OBJECTIVE
  People hospitalized for depression are often discharged before the acute phase of their illness has resolved and need timely care transitions to prevent relapse. We examined 30-day postdischarge service use for Ontarians, aged 15 years or older, who were hospitalized for depression. We focused on a pattern consistent with guideline and policy directions: higher rates of physician visits, postdischarge, combined with lower rates of emergency department (ED) admissions or rehospitalization.
  
  
  METHODS
  Administrative data for the fiscal year of 2005 were used to identify hospitalizations for depression and subsequent physician visits, ED admissions, or readmissions for depression within 30 days, postdischarge. Sex, age, income, and geographic location were examined along with the relation between health care resources (beds, EDs, and physicians) and postdischarge service use.
  
  
  RESULTS
  Sixty-three percent of patients discharged for depression were followed, within 30 days, by a physician visit for depression. Twenty-five percent were either rehospitalized or visited an ED. Women and people from urban or high income areas were more likely to have postdischarge physician visits. Readmissions and ED visits were correlated with number of EDs, but postdischarge physician visits were not related to the number of general practitioners, family physicians, and psychiatrists in the local area.
  
  
  CONCLUSIONS
  One-third of Ontarians hospitalized for depression did not receive recommended follow-up outpatient care within 30 days of discharge and one-quarter received follow-up through ED visits or readmissions, highlighting the need to improve coordination and integration across care settings for these patients. There are tested transitional and outpatient models that improve quality and outcomes of depression care that merit serious consideration.
authors: Centre for Addiction and Mental Health, Toronto, Ontario. elizabeth_lin@camh.net
authors: Elizabeth
authors: E
authors: Lin
authors: Natalia
authors: N
authors: Diaz-Granados
authors: Donna E
authors: DE
authors: Stewart
authors: Arlene S
authors: AS
authors: Bierman
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003866:Depressive Disorder / Q000628:therapy*; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008605:Mental Health Services; D008875:Middle Aged; D009864:Ontario; D010351:Patient Discharge; D010359:Patient Readmission / Q000706:statistics & numerical data; D055502:Secondary Prevention; D012959:Socioeconomic Factors; D000078329:Workforce; D055815:Young Adult