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Substance Abuse and Mental Health Services Administration
Intersite Variation in the Impact of Intensive Psychiatric Community Care on Hospital Use
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Explored the differences among 9 Veterans Affairs treatment facilities in the effectiveness of intensive psychiatric community care (IPCC) for reducing hospital dependence over a 5-yr period. This study also characterized the service delivery at the overall facility level and studied the relationship between IPCC program effectiveness and patterns of service delivery to determine whether specific site characteristics or time trends in patterns of service delivery were associated with greater or lesser effectiveness of the IPCC treatment. 345 patients (mean age 35 yrs) from neuropsychiatric hospitals and 528 patients (mean age 44 yrs) from general medical and surgical hospitals participated. Findings show that IPCC was most effective where former orientation to inpatient care was changing to improved accessibility of outpatient services. These IPCC programs resulted in substantially reduced hospital utilization among persons with severe and persistent mental illness. These hospitals appeared to have the greatest need for community care programs and to be most committed to shifting their system of service delivery. (Authors)