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Correlates of Emergency Department Use by Individuals With Bipolar Disorder Enrolled in a Collaborative Care Implementation Study.

Waxmonsky J, Verchinina L, Kim HM, Lai Z, Eisenberg D, Kyle JT, Nord KM, Rementer JH, Goodrich DE, Bauer MS, Thomas MR, Kilbourne AM. Correlates of Emergency Department Use by Individuals With Bipolar Disorder Enrolled in a Collaborative Care Implementation Study. Psychiatric services (Washington, D.C.). 2016 Nov 1; 67(11):1265-1268.

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Abstract:

OBJECTIVE: The study assessed correlates of emergency department use among participants in a collaborative care program for bipolar disorder. METHODS: Community-based clinics from two states implemented Life Goals-Collaborative Care (LG-CC), an evidence-based model that includes self-management sessions and care management contacts. Logistic regression determined participant factors associated with emergency department use between six and 12 months after LG-CC implementation. RESULTS: Of 219 participants with baseline and 12-month data, 24% reported at least one emergency department visit. Participants with a recent homelessness history (odds ratio [OR] = 3.76, p = .01) or five or more care management contacts (OR = 2.62, p = .05) had a higher probability of visiting an emergency department, after the analyses were adjusted for demographic and clinical factors, including physical health score and hospitalization history. CONCLUSIONS: Participants in a collaborative care program who had a history of homelessness were more likely to use the emergency department, suggesting a greater need for more intensive care coordination.





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