Abstract：
OBJECTIVE:To characterize the US national level healthcare utilization patterns of patients with commercial insurance plans before and after a psychiatric hospitalization admitted through the emergency department (ED) using insurance claims data. METHOD:We identified 34,250 patients from multiple commercial health insurance providers across the US who meet our eligibility criteria. We summarized their healthcare encounters and used logistic regression models to study the patterns of healthcare utilization including prior visits, outpatient follow-ups, and hospital- or ED-readmissions. RESULTS:Suicidal ideation was highly prevalent at the time of the index event (29.88%). Almost half of the patients (48.28%) had healthcare encounters with the same primary diagnosis one year before admission, about 5% had outpatient follow-ups or were readmitted to the hospital or ED 7 days post discharge. The post 30-day follow-ups and readmission rates were slightly higher. In general, older patients were less likely to have prior visits, follow-ups, or readmissions, and patients with SUDs, specifically alcohol dependence, opioid dependence/abuse, and stimulant dependence, were more likely to have outpatient follow-ups. CONCLUSION:Patterns of patients' prior visits, follow-ups, and readmissions varied by demographics and psychiatric comorbidity. Additional studies are needed to further explain the spatial variations of utilization patterns.
journal_name
Gen Hosp Psychiatryjournal_title
General hospital psychiatryauthors
Xi W,Banerjee S,Penfold RB,Simon GE,Alexopoulos GS,Pathak Jdoi
10.1016/j.genhosppsych.2020.10.001subject
Has Abstractpub_date
2020-01-01 00:00:00pages
92-99eissn
0163-8343issn
1873-7714pii
S0163-8343(20)30139-0journal_volume
67pub_type
杂志文章abstract：OBJECTIVE:The objective was to describe continuity of care approaches for psychiatric emergencies in the emergency department. METHODS:A national survey of all 138 academic emergency departments in the United States was conducted. RESULTS:Most emergency physicians (81%) had no systematic method for identifying psychi...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2011.05.020
更新日期：2011-11-01 00:00:00
abstract：OBJECTIVE:To assess the following among women hospitalized antenatally due to high-risk pregnancies: (1) rates of depression symptoms and anxiety symptoms, (2) changes in depression symptoms and anxiety symptoms and, (3) rates of mental health treatment. METHODS:Sixty-two participants hospitalized for high-risk obstet...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2014.07.011
更新日期：2014-11-01 00:00:00
abstract：:A number of reports have suggested that some cases of multiple personality disorder might be due to temporal lobe epileptic discharges. We have administered a structured interview, the Dissociative Disorders Interview Schedule, to 20 subjects with multiple personality disorder, 20 with complex partial seizures, and 28...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/0163-8343(89)90026-1
更新日期：1989-01-01 00:00:00
abstract：OBJECTIVE:To explore the hypothesis that environmental stress in the form of construction on a postpartum ward may be associated with enhanced maternal anxiety. METHODS:Four hundred twenty-two mothers delivering at a university hospital were screened prior to discharge for anxiety using the State Scale of the State Tr...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2007.08.010
更新日期：2007-11-01 00:00:00
abstract：:Bromocriptine, an ergot alkaloid dopamine agonist, is a recent common treatment for suppression of lactation in postpartum women. A case is presented of a postpartum woman prescribed bromocriptine for suppression of lactation who developed hypertension, headaches, blurry vision, seizures, and pituitary hemorrhage. Dif...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/0163-8343(91)90131-f
更新日期：1991-07-01 00:00:00
abstract：:Every day there are 6000-7000 papers published in science. Since the C-L psychiatrist may be asked to consult on a patient with any medical illness, and who may be on any medical drug, methods need to be developed to review the recent literature and have an awareness of current findings. At the same time, teachers nee...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/s0163-8343(99)00049-3
更新日期：1999-11-01 00:00:00
abstract：OBJECTIVES:We examined whether primary care patients were more likely to perceive a current health problem as 'physical illness only' as opposed to entailing psychological difficulties if they had a comorbid somatoform disorder compared to patients who had (a) both comorbid somatoform disorder and anxiety/depression or...
journal_title：General hospital psychiatry
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.genhosppsych.2015.01.002
更新日期：2015-03-01 00:00:00
abstract：:The authors present a case of dietary vitamin B12 deficiency in a patient with multiple sclerosis. A simple schemata for evaluating patients for vitamin B12 deficiency is included as a clinical aid for physicians. ...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/0163-8343(94)90105-8
更新日期：1994-05-01 00:00:00
abstract：:The paper examines the evidence regarding the extent to which differences exist in health and mental health status of psychiatric patients treated in the specialty mental health, general medical, and informal care sectors. Differences in types of patients treated in the three sectors are important to identify since th...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/0163-8343(90)90032-8
更新日期：1990-01-01 00:00:00
abstract：OBJECTIVE:This study examined age group differences in the rates of depression diagnosis and treatment using a national probability sample. METHODS:Using data from the 2012 National Ambulatory Medical Care Survey (n=62,723 visits by patients aged 18+ years), we used bivariate and multivariable binary logistic regressi...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2016.08.002
更新日期：2016-01-01 00:00:00
abstract：OBJECTIVE:To describe a patient with behavioral variant frontotemporal dementia (bvFTD) presenting with impulse control disorders (ICDs) which responded to fluvoxamine and topiramate. CASE REPORT:A 64-year-old woman was affected by several ICDs. At disease onset, she suffered from impulsive smoking and overeating whic...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2014.06.005
更新日期：2014-11-01 00:00:00
abstract：:This study reports DSM-III diagnoses and demographic characteristics of 100 patients consecutively referred to a university hospital consultation-liaison service for evaluation of medically unexplained symptoms suggesting physical disorders. Thirty-seven percent of patients received diagnoses of somatoform, dissociati...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/0163-8343(85)90006-4
更新日期：1985-01-01 00:00:00
abstract：:Sexual abuse is a common problem among female primary care medical patients. There is a wide spectrum of long-term sequelae, ranging from mild to the complex symptom profiles consistent with the theories of a posttraumatic sense of identity. Generally, the latter occurs in the context of severe, chronic abuse, beginni...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/s0163-8343(98)00021-8
更新日期：1998-07-01 00:00:00
abstract：:Psychiatry needs to conduct more rigorously designed empirical research studies to demonstrate its cost-effectiveness, especially since the DRG era is becoming more firmly established. The effectiveness of psychiatric intervention can be evaluated on its abilities to improve physical functioning as well as its improve...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/0163-8343(85)90050-7
更新日期：1985-10-01 00:00:00
abstract：OBJECTIVE:Post-intensive care syndrome (PICS), which encompasses profound psychological morbidity, affects many survivors of critical illness. We hypothesize that acute psychological stress during the intensive care unit (ICU) confinement likely contributes to PICS. In order to develop strategies that mitigate PICS ass...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2017.04.009
更新日期：2017-07-01 00:00:00
abstract：:Appreciation of the role of milieu in psychiatry has waxed and waned in response to various scientific, ideologic, and social pressures. In this review, historical trends in the use of environment in treatment of mental illness are integrated with social science and empirical research studies of milieu. While the insi...
journal_title：General hospital psychiatry
pub_type： 杂志文章,评审
doi：10.1016/0163-8343(82)90030-5
更新日期：1982-04-01 00:00:00
abstract：OBJECTIVE:This study examined whether there were racial/ethnic differences in the prevalence of antenatal depression based on Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, diagnostic criteria in a community-based sample of pregnant women. METHOD:Data were drawn from an ongoing registry of preg...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2010.11.012
更新日期：2011-03-01 00:00:00
abstract：OBJECTIVE:To report a case of Alzheimer's disease (AD) following mild traumatic brain injury (TBI). METHOD:Case report. RESULTS:We report the time course of AD following mild TBI with evidence of AD pathology. A patient complained of minor memory disturbance 6 months after TBI and was diagnosed with mild cognitive im...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2014.09.016
更新日期：2015-01-01 00:00:00
abstract：:Using a standardized measure of health beliefs, this study sought to disentangle factors that contribute to increased medical service use in a sample of 64 high-utilizing elderly patients. In adjusted models, people with depressive symptoms were more likely than those without depression to believe that they were susce...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2004.09.010
更新日期：2005-03-01 00:00:00
abstract：OBJECTIVE:This naturalistic prospective study explored the predictors of laboratory test ordering in a psychiatric emergency department. METHODS:We used a standardized questionnaire to collect clinical and nonclinical features in 527 consecutive patients. RESULTS:Test ordering was independently predicted by age, spok...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2008.02.005
更新日期：2008-07-01 00:00:00
abstract：:Linkages between psychiatry and other medical specialties have become increasingly evident over the past decade. Reinstatement of the medical internship for psychiatric trainees, expansion of psychiatric liaison services, growth of general hospital psychiatric units, determination of the extensive role served by nonps...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：
更新日期：1983-07-01 00:00:00
abstract：:Hashimoto's encephalopathy (HE), which carries kaleidoscopic clinical presentations, is easily misdiagnosed in clinical practice. Early diagnosis and prompt initiation of steroid therapy are associated with good prognosis. We describe a 50-year-old female patient who had subclinical hypothyroidism and who presented he...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2014.01.006
更新日期：2014-05-01 00:00:00
abstract：:The variability in estimated rates of major depressive disorder (MDD) in chronic pain samples may be accounted for by sample and methodological differences. Most studies rely on a single measure of depression and lack independent or repeated measures. This study investigated the prevalence of psychiatric disorders in ...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/0163-8343(95)00088-7
更新日期：1995-11-01 00:00:00
abstract：OBJECTIVE:Special observation (the allocation of nurses to watch over nominated patients) is a method of preventing patients harming themselves. This study assessed the relationship between constant special observation (keeping a patient within eyesight or reach) and rates of self-harm on acute psychiatric wards. METH...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2009.05.008
更新日期：2009-11-01 00:00:00
abstract：:Diligence in the interpretation of results is essential as information gained from the psychiatric patient's history might often be restricted. Nonobservance of established guidelines may lead to a wrong diagnosis, induce a false therapy and result in life-threatening situations. Communication errors between hospitals...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2010.03.002
更新日期：2010-09-01 00:00:00
abstract：:Prospective data were gathered from 388 psychiatric consultations performed in a general hospital setting. Data included demographic, medical, psychiatric, and illness behavior characteristics of the patients seen, as well as consultant functions and recommendations. Results indicate that consulted patients suffer fro...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/0163-8343(80)90063-8
更新日期：1980-09-01 00:00:00
abstract：:As part of a population study on the prevalence of psychopathology, users of "Over-The-Counter" Psychotropics (OTC-Ps) were studied. First, their mental health profile was examined by a number of subjective and objective assessments. Second, the medical consumption of the users was studied with special attention to th...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/s0163-8343(00)00078-5
更新日期：2000-07-01 00:00:00
abstract：OBJECTIVE:The goal of this analysis was to examine the effect of benzodiazepine use during pregnancy on maternal and neonatal outcomes in a cohort of women with psychiatric disorders. METHODS:794 evaluable women from the Massachusetts General Hospital National Pregnancy Registry for Psychiatric Medications were follow...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2018.05.010
更新日期：2018-01-01 00:00:00
abstract：:In the Netherlands, the prescription of beta-blockers to patients older than 70 years has increased sharply in recent years. The neuropsychiatric adverse reactions associated with the use of beta-blockers are relatively uncommon and they are mostly seen with poisoning or overdose. We describe an 81-year-old man who de...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2010.04.008
更新日期：2010-11-01 00:00:00
abstract：:The present study aims to validate the Spanish version of the Hospital Anxiety and Depression Scale (HADS) and to determine the use of this tool for screening mood and anxiety disorders. Psychometric properties of the HADS were assessed in different groups of general medical outpatients attending the Hospital Clínic i...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/s0163-8343(03)00043-4
更新日期：2003-07-01 00:00:00
