Hospitalization Rates in Early Psychosis: 48 Month Outcomes for Rural Coordinated Specialty Care and Community Care Programs

Betty DeAngelis, LICSW (1), Cassidy Lewis, BA (1), Melissa Weise, LICSW, PhD (1,2) John Knutsen, PhD (1,3)

1. ServiceNet Inc., Northampton, MA
2. School of Social Work, Smith College
3. Department of Psychology, Harvard University, Cambridge, MA

Abstract

Background: Hospitalization usage remains a significant contribution to overall health care costs in early psychosis, is associated with amplified symptom presentation, and can negatively impact treatment and intervention goals. However, hospitalization usage (and risk) has been shown to be markedly reduced in individuals who participate in coordinated specialty care programs (CSC) compared to usual care. Prevention and Recovery in Early Psychosis-West (PREP), a CSC for individuals living with early psychosis in Western MA, provides intensive, comprehensive, evidence-based outpatient milieu treatment for young adults to stabilize their lives, recover, and resume developmentally appropriate social and role functioning in their communities. Here we provide hospitalization rates data for individuals with early psychosis who participated in the PREP program and for those who received usual care over the past 48 months.
Methods: Descriptive analyses were used to explore demographic and inpatient psychiatric hospitalization rates (IPH) data from electronic health records for all PREP clients and usual care clients who received services for a minimum of three months between March 01, 2018, and March 31, 2022.
Results: Between 03/01/2018 and 03/31/2022 22% (n=78) of PREP clients had at least one hospitalization with an average IPH admission rate of 1.17 and a duration mean of 5.32 days, while 67% (n=30) of early psychosis individuals receiving usual care had at least one hospitalization with an average IPH admission rate of 2.20 and duration mean of 39.15 days.
Conclusion: Access to care and hospitalization usage remain robust challenges for young adults living with early psychosis in Western MA. However, in the past 48 months participants in the PREP program have demonstrated a markedly reduced overall IPH admission rate and duration compared to usual care. These data support the impact that a rural CSC can have on hospitalization usage in early psychosis when compared to usual care.