title: Post-inpatient attrition from care "as usual" in veterans with multiple psychiatric admissions.
abstract: Disengagement from outpatient care following psychiatric hospitalization is common in high-utilizing psychiatric patients and contributes to intensive care utilization. To investigate variables related to treatment attrition, a range of demographic, diagnostic, cognitive, social, and behavioral variables were collected from 233 veterans receiving inpatient psychiatric services who were then monitored over the following 2 years. During the follow-up period, 88.0 % (n = 202) of patients disengaged from post-inpatient care. Attrition was associated with male gender, younger age, increased expectations of stigma, less short-term participation in group therapy, and poorer medication adherence. Of those who left care, earlier attrition was predicted by fewer prior-year inpatient psychiatric days, fewer lifetime psychiatric hospitalizations, increased perceived treatment support from family, and less short-term attendance at psychiatrist appointments. Survival analyses were used to analyze the rate of attrition of the entire sample as well as the sample split by short-term group therapy attendance. Implications are discussed.
authors.affiliation: Serious Mental Illness Treatment Research and Evaluation Center, North Campus Research Complex, 2800 Plymouth Rd, Building 10 6016, Ann Arbor, MI, 48109-2800, USA, nbowersox@yahoo.com.
authors.forename: Nicholas W
authors.initials: NW
authors.lastname: Bowersox
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Saunders
authors.forename: Bertrand
authors.initials: B
authors.lastname: Berger
mesh_terms: D000367:Age Factors; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000523:psychology / Q000628:therapy*; D008875:Middle Aged; D010343:Patient Admission / Q000706:statistics & numerical data; D010349:Patient Compliance / Q000523:psychology* / Q000706:statistics & numerical data; D010358:Patient Participation / Q000523:psychology / Q000706:statistics & numerical data; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D012737:Sex Factors; D012944:Social Support; D011795:Surveys and Questionnaires; D014481:United States; D014728:Veterans / Q000523:psychology* / Q000706:statistics & numerical data