Evidence map›Paper›PMID 34214935›Full record

ArticleGeneral hospital psychiatry

Irregular hospital discharge from acute inpatient and residential mental health treatment settings in a large integrated healthcare system.

Natalie B Riblet, Daniel J Gottlieb, Bradley V Watts, Maxwell Levis, Brian Shiner

Registry-linked trialOpen access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in General hospital psychiatry. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04446468 (Prevention of Suicide in Veterans Through Brief Intervention and Contact), which is not on this map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.7field-weighted citation impact, top 29% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04446468 nacompletednot on this map

Prevention of Suicide in Veterans Through Brief Intervention and Contact (VA-BIC)

TypeinterventionalSponsorVA Office of Research and DevelopmentRan2021 to 2025Enrolled92ConditionsSuicide PreventionArmsPEACE, Standard Psychiatric Hospital Discharge Care
3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 4 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 2 institutions in 1 country.

Natalie B RibletVeterans Affairs Medical Center, 215 North Main Street, White River Junction, VT 05009, USA; Geisel School of Medicine at Dartmouth College, 1 Rope Ferry Road, Hanover, NH 03755, USA. Electronic address: Natalie.Riblet@dartmouth.edu.
Daniel J GottliebVeterans Affairs Medical Center, 215 North Main Street, White River Junction, VT 05009, USA. Electronic address: Daniel.Gottlieb2@va.gov.
Bradley V WattsVeterans Affairs Medical Center, 215 North Main Street, White River Junction, VT 05009, USA; Geisel School of Medicine at Dartmouth College, 1 Rope Ferry Road, Hanover, NH 03755, USA; VA Office of Systems Redesign and Improvement, 215 North Main Street, White River Junction, VT 05009, USA. Electronic address: Bradley.Watts@va.gov.
Maxwell LevisVeterans Affairs Medical Center, 215 North Main Street, White River Junction, VT 05009, USA; Geisel School of Medicine at Dartmouth College, 1 Rope Ferry Road, Hanover, NH 03755, USA. Electronic address: MaxwellE.Levis@va.gov.
Brian ShinerVeterans Affairs Medical Center, 215 North Main Street, White River Junction, VT 05009, USA; Geisel School of Medicine at Dartmouth College, 1 Rope Ferry Road, Hanover, NH 03755, USA; National Center for PTSD, 215 North Main Street, White River Junction, VT 05009, USA. Electronic address: Brian.Shiner@va.gov.
White River Junction VA Medical Center · USDartmouth College · US

Funding

CSRD VA IK2 CX001920Intramural VA VA999999
6 · The paper itself

Abstract

objectiveIrregular discharge is a concern among mental health populations and associated with poor outcomes. Little is known about the relationship between irregular discharge and treatment setting. Because care processes differ between acute inpatient and residential settings, it is important to evaluate irregular discharge in these settings.

methodA retrospective study was conducted in patients with mental health conditions admitted to acute inpatient or residential mental health settings in the Department of Veterans Affairs, 2003-2019. Logistic regression and multivariate Cox proportional hazards were used to evaluate factors associated with irregular discharge risk in the first 90- days of admission.

resultsAmong 1.8 million discharges, 7.4% had an irregular discharge within 90- days of admission. Younger age was a central predictor of risk. Irregular discharge rates were four-fold higher in residential versus acute settings. When accounting for length of stay (LOS) across settings, there was a modest higher risk of irregular discharge from acute versus residential settings (HR = 1.06, 95% Confidence Interval 1.04-1.07).

conclusionsPatients are at high risk for irregular discharge from acute and residential settings when they are young. LOS is an important determinant of irregular discharge risk.. Interventions are needed to address drivers of irregular discharge.

Indexed as

Delivery of Health Care, IntegratedPatient DischargeHospitalsHumansInpatientsLength of StayMental HealthRetrospective StudiesAcute mental health treatmentAgainst medical advice dischargeIrregular dischargeResidential treatment

Identifiers

PMID34214935
PMCPMC8801293
OpenAlexW3176337553

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.