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Predictors of psychiatric aftercare among formerly hospitalized adolescents.
- Source :
-
Canadian journal of psychiatry. Revue canadienne de psychiatrie [Can J Psychiatry] 2012 Nov; Vol. 57 (11), pp. 666-76. - Publication Year :
- 2012
-
Abstract
- Objective: Timely aftercare can be viewed as a patient safety imperative. In the context of decreasing inpatient length of stay (LOS) and known child psychiatry human resource challenges, we investigated time to aftercare for adolescents following psychiatric hospitalization.<br />Method: We conducted a population-based cohort study of adolescents aged 15 to 19 years with psychiatric discharge between April 1, 2002, and March 1, 2004, in Ontario, using encrypted identifiers across health administrative databases to determine time to first psychiatric aftercare with a primary care physician (PCP) or a psychiatrist within 395 days of discharge.<br />Results: Among the 7111 adolescents discharged in the study period, 24% had aftercare with a PCP or a psychiatrist within 7 days and 49% within 30 days. High socioeconomic status (adjusted hazard ratio [AHR] 1.31; 95% CI 1.21 to 1.43, P < 0.001) and psychotic disorders (AHR 1.24; 95% CI 1.12 to 1.36, P < 0.001) were associated with greater likelihood of aftercare. Youth in the northern part of the province (AHR 0.48; 95% CI 0.32 to 0.71, P < 0.001), rural areas (AHR 0.82; 95% CI 0.76 to 0.89, P < 0.001), and with self-harm or suicide attempts (AHR 0.58; 95% CI 0.53 to 0.64, P < 0.001) and substance use disorders (AHR 0.50; 95% CI 0.44 to 0.56, P < 0.001) were less likely to receive aftercare.<br />Conclusions: Hospitalization is our most intensive, intrusive, and expensive psychiatric treatment setting, yet in our cohort of formerly hospitalized adolescents fewer than 50% received psychiatry-related aftercare in the month postdischarge. Innovations are necessary to address geographic inequities and improve timely access to mental health aftercare for all youth.
- Subjects :
- Adolescent
Aftercare statistics & numerical data
Cohort Studies
Female
Health Services Accessibility statistics & numerical data
Humans
Likelihood Functions
Male
Mental Disorders diagnosis
Mental Disorders epidemiology
Mental Disorders psychology
Ontario
Primary Health Care statistics & numerical data
Psychiatry statistics & numerical data
Psychotic Disorders diagnosis
Psychotic Disorders epidemiology
Psychotic Disorders psychology
Psychotic Disorders therapy
Retrospective Studies
Rural Population statistics & numerical data
Self-Injurious Behavior diagnosis
Self-Injurious Behavior epidemiology
Self-Injurious Behavior psychology
Self-Injurious Behavior therapy
Socioeconomic Factors
Substance-Related Disorders diagnosis
Substance-Related Disorders epidemiology
Substance-Related Disorders psychology
Substance-Related Disorders therapy
Suicide, Attempted prevention & control
Suicide, Attempted psychology
Suicide, Attempted statistics & numerical data
Utilization Review statistics & numerical data
Aftercare psychology
Hospitalization
Mental Disorders therapy
Subjects
Details
- Language :
- English
- ISSN :
- 0706-7437
- Volume :
- 57
- Issue :
- 11
- Database :
- MEDLINE
- Journal :
- Canadian journal of psychiatry. Revue canadienne de psychiatrie
- Publication Type :
- Academic Journal
- Accession number :
- 23149282
- Full Text :
- https://doi.org/10.1177/070674371205701104