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Efficacy of transitional case management following psychiatric hospital discharge: a randomized trial

English title Efficacy of transitional case management following psychiatric hospital discharge: a randomized trial
Applicant Bonsack Charles
Number 118347
Funding scheme Project funding (Div. I-III)
Research institution Section accueil et interventions brèves - Consultation générale et consilium
Institution of higher education University of Lausanne - LA
Main discipline Neurology, Psychiatry
Start/End 01.03.2008 - 31.08.2010
Approved amount 172'397.00
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Keywords (4)

case management; psychiatric hospitalization; hospital discharge; community psychiatry

Lay Summary (English)

Lead
Lay summary
The aims of this study is to develop a brief case management intervention during the month following psychiatric hospitalization and to test its efficacy vs routine care. Context: The movement of deinstitutionalisation in Western societies has modified the role of psychiatric hospital, which has lost its asylum function to become a place for acute care. Psychiatric stays are now shorter and close interactions with the outpatient care network is therefore more critical than before. The first weeks following discharge from psychiatric hospital represent a period of high risk for relapse, readmission or even suicide. Case management has a proven efficacy in facilitating patients’ deinstitutionalisation after very long hospitalisations and in stabilizing high users of psychiatric care. In contrast, studies exploring the impact of time limited case management following discharge from short stays (transitional case management) in earlier phases of psychiatric disorders in connection with primary care are lacking. Working hypotheses: We hypothesize that transitional case management following hospital discharge decreases risk of readmission, improves adherence to outpatient care, facilitates recovery and improves patients’ satisfaction with treatment as compared to routine care. Specific aims: we will compare the impact of both intervention on number of contact and level of adherence to outpatient care. We will also compare both groups on number of readmission, risk of early aggravation of the disorders, level of functioning and satisfaction with care. Methods: This is a randomized single-blind study comparing transitional case management after discharge with routine post-hospitalization care for subjects living independently without institutional psychiatric follow-up. Demographic and clinical data will be gathered during indexhospitalization, and 1, 3, 6 and 12 months after discharge. Quantitative assessement of outcomes using validated instruments will be: contact and level of adherence to outpatient care (primary outcomes), as well as number of hospitalization days, number of readmissions, severity of illness and satisfaction with care (secondary outcomes). Expected value of the project: This study should improve psychiatric patients follow-up in collaboration with the different levels of care in the global context of deinstitutionalization.
Direct link to Lay Summary Last update: 21.02.2013

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