Title

Post-inpatient Attrition from Care “As Usual” in Veterans with Multiple Psychiatric Admissions

Document Type

Article

Language

eng

Publication Date

12-2013

Publisher

Springer

Source Publication

Community Mental Health Journal

Source ISSN

0010-3853

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.

Comments

Community Mental Health Journal, Vol. 49, No. 6 (December 2013): 694-703. DOI.

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