Date of Award

5-13-2016

Degree Type

Capstone Project

Degree Name

Master of Public Health (MPH)

Department

Public Health

First Advisor

Dr. Douglas Roblin

Second Advisor

Dr. Ashli Owen-Smith

Abstract

Increasing the rate of timely follow up care for individuals who have been recently discharged from inpatient psychiatric care has been a goal of the US health care system for some time. Attempts at improving this rate through strategies such as care management, Critical Time Intervention, and comprehensive discharge planning have modestly improved rates, but further improvement should be possible.

A review of previously conducted research in this field indicates the need for a more focused analysis of the determinants of successful follow-up care strategies. Viewing individuals who have been discharged from inpatient psychiatric care as a single population may be an erroneous way of approaching this issue. The population of individuals who have been recently discharged from inpatient psychiatric care is heterogeneous, and strategies for improving continuity of care may be improved by tailoring intervention strategies to the specific characteristics and needs of subgroups of individuals being discharged from inpatient care. As such, this proposed study will focus on a narrower group of patients: those recently discharged from an inpatient psychiatric facility with a co-occurring chemical dependency diagnosis who live in a non-rural setting.

This research proposal suggests a methodology by which to study the potentially complex interactions between patient characteristics and interventions. The intended population is adults who were hospitalized for acute psychiatric care and who have comorbid chemical dependencies. Utilization of Medicaid claims data used with information gathered from insurers and inpatient facilities can provide information about whether or not a Medicaid patient has received timely follow up care. Discharge and post-discharge interventions put into place can be determined through a survey of the facilities regarding discharge procedures. This data can be used to evaluate the comparative effectiveness of the interventions offered at the various settings of care.

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