title: Decertification outcomes for bipolar disorder in an inpatient community mental health treatment center: impact on subsequent service use over two years.
abstract: This study investigated differences in usage of inpatient and outpatient mental health services over a 2-year period following the index hospitalization between 50 decertified and 48 certified subjects with bipolar manic or mixed episode from an inpatient mental health treatment center. The decertified group had higher number of rehospitalization over the 2-year period compared to certified group (mean = 2.26, SE = 0.41 vs. mean = 1.19, SE = 0.24; Wald χ                 (2) = 5.50, p = 0.02). Median time to first rehospitalization was 40 weeks in the certified and 17 weeks in the decertified group, but the difference in time to rehospitalization failed to achieve statistical significance (p = 0.18). History of prior hospitalization was associated with higher numbers of rehospitalizations and crisis room visits (both p < 0.01) and with shorter time before first rehospitalization (p < 0.001).
authors.affiliation: Department of Psychiatry and Behavioral Sciences, University of California at Davis, Davis, CA, USA. glen.xiong@ucdmc.ucdavis.edu
authors.forename: Glen L
authors.initials: GL
authors.lastname: Xiong
authors.forename: Ana-Maria
authors.initials: AM
authors.lastname: Iosif
authors.forename: Ana-Maria
authors.initials: AM
authors.lastname: Iosiff
authors.forename: Michael
authors.initials: M
authors.lastname: Brooks
authors.forename: Charles L
authors.initials: CL
authors.lastname: Scott
authors.forename: Donald M
authors.initials: DM
authors.lastname: Hilty
mesh_terms: D000328:Adult; D000368:Aged; D000553:Ambulatory Care / Q000706:statistics & numerical data*; D001714:Bipolar Disorder / Q000628:therapy*; D002140:California; D003155:Community Mental Health Centers; D003156:Community Mental Health Services / Q000706:statistics & numerical data*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007297:Inpatients; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010342:Patient Acceptance of Health Care; D010351:Patient Discharge / Q000706:statistics & numerical data*; D010359:Patient Readmission / Q000706:statistics & numerical data*; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D013997:Time Factors; D016312:Treatment Refusal; D014600:Utilization Review