Objective: To determine whether continuity of care (COC) reduces emergency department (ED) visits and/or readmission in adolescents with psychiatric disorders. Methods: A retrospective cohort of adolescents discharged with psychiatric disorder between April 1, 2002 and March 1, 2004 was identified using hospital administrative databases. Good COC was defined as at least one aftercare contact in 30 days. Confounding by patient characteristics was adjusted for by propensity-score-matching of good and poor COC adolescents. Cox PH was used to analyze time to outcome. Results: 48.77% of adolescents had good COC. 38.39% of adolescents had ED visit or readmission in the year post-discharge. Good COC increased risk of readmission (HR = 1.38 (1.14 – 1.66)), but not of ED visits (HR = 1.14 (0.95 – 1.37)). Conclusions: COC increased risk of readmission by 38% but did not increase risk of ED visits. These findings are contextualized. Implications to adolescent mental health service delivery are discussed.
| Identifer | oai:union.ndltd.org:TORONTO/oai:tspace.library.utoronto.ca:1807/25443 |
| Date | 15 December 2010 |
| Creators | Carlisle, Corine Elizabeth |
| Contributors | To, Teresa |
| Source Sets | University of Toronto |
| Language | en_ca |
| Detected Language | English |
| Type | Thesis |
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