Care plans reduce risk of ending up in hospital for patients with severe mental illness: study

November 06, 2019

The chances of a patient with a serious mental illness ending up in hospital because of their condition are reduced by almost 40 per cent if they have a care plan, according to the research.

The study, which tracked 20,000 patients with a severe mental illness through the healthcare system, also found that seeing the same GP reduced the risk of an unplanned hospital admission by around 25 per cent.

The findings demonstrate the importance of continuity of care at the GP's for improving health outcomes for patients with a severe mental illness, the authors of the study say.


Objective: To  investigate  whether  continuity  of  care  in  family  practice  reduces  un-planned hospital use for people with serious mental illness (SMI).Data Sources: Linked administrative data on family practice and hospital utilization by people with SMI in England, 2007-2014.

Study  Design:  This  observational  cohort  study  used  discrete-time  survival  analy-sis  to  investigate  the  relationship  between  continuity  of  care  in  family  practice  and  unplanned  hospital  use:  emergency  department  (ED)  presentations,  and  unplanned  admissions  for  SMI  and  ambulatory  care-sensitive  conditions  (ACSC).  The  analysis  distinguishes between relational continuity and management/ informational continu-ity (as captured by care plans) and accounts for unobserved confounding by examin-ing deviation from long-term averages.Data Collection/Extraction Methods: Individual-level family practice administrative data linked to hospital administrative data.

Principal  Findings:  Higher  relational  continuity  was  associated  with  8-11  percent  lower risk of ED presentation and 23-27 percent lower risk of ACSC admissions. Care plans  were  associated  with  29  percent  lower  risk  of  ED  presentation,  39  percent  lower risk of SMI admissions, and 32 percent lower risk of ACSC admissions.

Conclusions: Family practice continuity of care can reduce unplanned hospital use for physical and mental health of people with SMI.

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