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Please use this identifier to cite or link to this item: http://hdl.handle.net/1807/25443

Title: Continuity of Care, Emergency Department Visits and Readmission in Adolescents with Psychiatric Disorders: A Retrospective Cohort Study using Propensity Score Matching
Authors: Carlisle, Corine Elizabeth
Advisor: To, Teresa
Department: Health Policy, Management and Evaluation
Keywords: child
adolescent
mental health
psychiatric disorders
mental health services
epidemiology
continuity of care
aftercare
hospitalization
psychiatric hospitalization
emergency services, psychiatric
emergency department visits
health status disparities
health services utilization
observational studies
follow-up studies
propensity scores
Bias
Issue Date: 15-Dec-2010
Abstract: Objective: To determine whether continuity of care (COC) reduces emergency department (ED) visits and/or readmission in adolescents with psychiatric disorders. Methods: A retrospective cohort of adolescents discharged with psychiatric disorder between April 1, 2002 and March 1, 2004 was identified using hospital administrative databases. Good COC was defined as at least one aftercare contact in 30 days. Confounding by patient characteristics was adjusted for by propensity-score-matching of good and poor COC adolescents. Cox PH was used to analyze time to outcome. Results: 48.77% of adolescents had good COC. 38.39% of adolescents had ED visit or readmission in the year post-discharge. Good COC increased risk of readmission (HR = 1.38 (1.14 – 1.66)), but not of ED visits (HR = 1.14 (0.95 – 1.37)). Conclusions: COC increased risk of readmission by 38% but did not increase risk of ED visits. These findings are contextualized. Implications to adolescent mental health service delivery are discussed.
URI: http://hdl.handle.net/1807/25443
Appears in Collections:Master
The Institute of Health Policy, Management and Evaluation - Master theses

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