Managing the Transition from Acute to Community Setting in Schizophrenia
Many patients with schizophrenia fail to transition from inpatient settings to the community mental health centre following discharge from hospital. It has been previously estimated that nearly two-thirds of patients do not attend their initial outpatient appointment. [Boyer et al., 2000]
Research has also shown that approximately 40% of patients will not receive any outpatient visits within 30 days of discharge. [Olfson et al. 2010]
Continuity of care in the community setting is heavily influenced by patient characteristics, the clinical management environment, and geographical resource availability. The inpatient and community management of patients with schizophrenia have different goals and challenges, and research shows that multiple risk factors increase the risk of missing community mental health centre appointments:
- Priebe et al. 2005 highlighted the importance of the patient being involved in treatment decisions.
- Compton et al. 2006 went further to show that a lack of an established outpatient clinician was also an important factor.
- Stein et al. 2007 showed that ethnicity, involuntary patient admission, discharge against medical advice, and substance abuse were also relevant risk factors.
- Olfson et al. 2010 meanwhile showed that a short inpatient stay (<4 days), and the absence of prior outpatient mental health care were significant factors.