Citation

La EM, Morrissey JP, Lich KH, Domino ME, Seibert J, Waller A. Psychiatr. Serv. 2017; 68(11): 1201-1204.

Affiliation

Dr. La is with RTI Health Solutions and Dr. Seibert is with RTI International, Research Triangle Park, North Carolina. Dr. Morrissey and Dr. Domino are with the Cecil G. Sheps Center for Health Services Research and the Department of Health Policy and Management, Dr. Lich is with the Department of Health Policy and Management, and Dr. Waller is with the Department of Emergency Medicine, all at the University of North Carolina at Chapel Hill.

Copyright

(Copyright © 2017, American Psychiatric Association)

DOI

10.1176/appi.ps.201600578

PMID

28806890

Abstract

OBJECTIVE: This study estimated the effects of a waitlist policy on the monthly number and case mix of admissions to state psychiatric hospitals (SPHs) in North Carolina (NC).

METHODS: Descriptive analyses compared pre/postwaitlist differences in the monthly number and case mix of nonforensic adult admissions (N=72,035) to NC's four SPHs by using data from the three years before and the three years after the waitlist announcement. Hospital-level fixed-effects regression models further evaluated the waitlist policy's impact on the number and case mix of admissions.

RESULTS: Regression results confirmed that the waitlist policy was associated with both fewer admissions and changes to the case mix of admissions, including a 4.2% decrease in the percentage of monthly admissions by patients with diagnoses of substance abuse disorders (p=.002) across all months postwaitlist (partially offset by an increase of patients with diagnoses of severe mental illness alone).

CONCLUSIONS: Waitlists led to reduced monthly admissions and altered case mix following implementation at NC SPHs.

Language: en

Keywords

Admissions & Case mix; Hospitalization; Inpatient treatment; State psychiatric hospitals; Waitlist