title: Intervention to reduce inpatient psychiatric admission in a metropolitan city.
abstract: When psychiatric hospitalization is over-used, it represents a financial drain and failure of care. We evaluated implementation and cessation of transporting people medically certified for psychiatric hospitalization to a central psychiatric emergency service for management and re-evaluation of hospitalization need. After implementation, the hospitalization rate declined 89% for 346 transported patients; only four of the nonhospitalized patients presented in crisis again in the next 30 days. Following cessation, the hospitalization rate jumped 59% compared to the preceding year. Costs declined 78.7% per diverted patient. The findings indicate that it is possible to reduce hospitalization and costs, and maintain quality care.
authors.affiliation: Department of Psychiatry and Behavioral Neurosciences, Wayne State University, 3901 Chrysler Drive, Detroit, MI, 48201, USA.
authors.forename: Alireza
authors.initials: A
authors.lastname: Amirsadri
authors.forename: Edward
authors.initials: E
authors.lastname: Mischel
authors.forename: Luay
authors.initials: L
authors.lastname: Haddad
authors.forename: Manuel
authors.initials: M
authors.lastname: Tancer
authors.forename: Cynthia L
authors.initials: CL
authors.lastname: Arfken
mesh_terms: D000328:Adult; D003156:Community Mental Health Services / Q000191:economics; D003362:Cost-Benefit Analysis; D003419:Crisis Intervention / Q000379:methods* / Q000706:statistics & numerical data; D004637:Emergency Services, Psychiatric / Q000191:economics / Q000379:methods*; D005260:Female; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data*; D006778:Hospitals, Psychiatric; D006801:Humans; D007297:Inpatients; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000628:therapy*; D008824:Michigan / Q000453:epidemiology; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D055815:Young Adult