Table 1.
Patient, hospital, and system characteristics associated with likelihood of not having an outpatient appointment scheduled as part of discharge planning.
| Total sample (N=18,185) | Did not receive (N=3,682) | Unadjusted models of no appointment scheduled | Adjusted models of no appointment scheduled (n=17,831) | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Patient Characteristics | N | N | % | Odds Ratio | 99% CI | Average Marginal Effect, % | 99% CI | Odds Ratio | 99% CI | p-value | Average Marginal Effect, % | 99% CI | p-value |
| Age | |||||||||||||
| 4–12 | 1,798 | 192 | 10.7 | ref | ref | ref | ref | ||||||
| 13–17 | 2,537 | 499 | 19.7 | 2.05 | 1.33, 3.16 | 8.99 | 2.25, 15.73 | 2.08 | 1.37, 3.16 | <.001 | 8.67 | 3.5, 13.85 | <.001 |
| 18–35 | 5,488 | 1,075 | 19.6 | 2.04 | 1.21, 3.44 | 8.91 | 3.18, 14.64 | 1.80 | 1.23, 2.63 | <.001 | 6.55 | 2.74, 10.36 | <.001 |
| 36–64 | 8,362 | 1,916 | 22.9 | 2.49 | 1.47, 4.20 | 12.23 | 6.22, 18.25 | 1.99 | 1.37, 2.88 | <.001 | 7.99 | 4.25, 11.73 | <.001 |
| Gender | |||||||||||||
| Female | 8,395 | 1,562 | 18.6 | ref | ref | ref | ref | ||||||
| Male | 9,790 | 2,120 | 21.7 | 1.21 | 1.06, 1.38 | 3.05 | .94, 5.16 | 1.10 | .97, 1.26 | .05 | 1.36 | −0.42, 3.15 | .05 |
| Race/ethnicity | |||||||||||||
| Non-Hispanic White | 7449 | 1239 | 16.3 | ref | ref | ref | ref | ||||||
| Non-Hispanic Black | 6056 | 1435 | 23.7 | 1.56 | 1.24, 1.96 | 7.06 | 3.40, 10.73 | .98 | .84, 1.14 | .77 | −.25 | −2.37, 1.88 | .77 |
| Puerto Rican - Hispanic | 1987 | 417 | 20.9 | 1.33 | 1.08, 1.65 | 4.35 | 1.20, 7.51 | .84 | .72, .97 | .00 | −2.35 | −4.35, −.34 | .00 |
| Other | 1409 | 361 | 25.6 | 1.73 | 1.32, 2.25 | 8.99 | 4.38, 13.60 | 1.02 | .85, 1.23 | .73 | .34 | −2.25, 2.93 | .74 |
| Unknown | 1284 | 230 | 17.9 | 1.09 | .71, 1.69 | 1.28 | −5.09, 7.65 | 1.04 | .76, 1.43 | .73 | .61 | −3.94, 5.16 | .73 |
| Length of stay | |||||||||||||
| 5–14 days | 9,309 | 1,784 | 19.2 | ref | ref | ref | ref | ||||||
| 0–4 days | 2,690 | 576 | 21.4 | 1.15 | .88, 1.50 | 2.25 | −2.22, 6.72 | 1.60 | 1.33, 1.92 | <.001 | 6.96 | 3.67, 10.24 | <.001 |
| 15–30 days | 4,740 | 975 | 20.6 | 1.09 | .89, 1.34 | 1.41 | −1.84, 4.65 | 1.07 | .94, 1.21 | .18 | .86 | −.82, 2.53 | .19 |
| 31–60 days | 1,446 | 347 | 24.0 | 1.33 | 1.03, 1.72 | 4.83 | .39, 9.27 | 1.45 | 1.17, 1.8 | <.001 | 5.36 | 1.88, 8.85 | <.0001 |
| Homeless at admission | |||||||||||||
| No | 16,046 | 2,914 | 18.2 | ref | ref | ref | ref | ||||||
| Yes | 1,283 | 399 | 31.1 | 2.03 | 1.52, 2.72 | 12.94 | 7.01, 18.87 | 1.32 | 1.06, 1.65 | .01 | 4.06 | .67, 7.44 | .01 |
| Primary diagnosis at discharge | |||||||||||||
| Schizophrenia | 4,998 | 1,068 | 21.4 | ref | ref | ref | ref | ||||||
| Schizoaffective | 1,844 | 379 | 20.6 | .95 | .75, 1.22 | −.82 | −4.86, 3.23 | 1.01 | .82, 1.25 | .88 | .16 | −2.60, 2.93 | .88 |
| Bipolar disorders | 5,968 | 1,274 | 21.4 | 1.00 | .77, 1.30 | −.02 | −4.41,4.37 | 1.19 | .99, 1.42 | .02 | 2.36 | −.17, 4.91 | .02 |
| Depressive disorders | 3,424 | 641 | 18.7 | .85 | .64, 1.12 | −2.65 | −7.03, 1.74 | 1.02 | .82, 1.26 | .84 | .22 | −2.62, 3.07 | .84 |
| Other disorders | 1,951 | 320 | 16.4 | .72 | .51, 1.05 | −4.97 | −10.45, .52 | 1.19 | .90, 1.53 | .08 | 2.37 | −1.20, 6.03 | .09 |
| Co-occurring substance use diagnosis at discharge | |||||||||||||
| No | 11,479 | 1,822 | 15.9 | ref | ref | ref | ref | ||||||
| Yes | 6,706 | 1,860 | 27.7 | 2.03 | 1.63, 2.54 | 11.86 | 7.67, 16.06 | 1.76 | 1.52, 2.05 | <.001 | 8.19 | 5.79, 10.6 | <.001 |
| Medical comorbidity in previous 12 months (non-behavioral health) | |||||||||||||
| 0 | 5,972 | 1,094 | 18.3 | ref | ref | ref | ref | ||||||
| 1–3 | 8,645 | 1,722 | 19.9 | 1.11 | .93, 1.32 | 1.60 | −1.04, 4.24 | 1.05 | .93, 1.18 | .33 | .63 | −1.02, 2.27 | .33 |
| 4 or higher | 3,383 | 832 | 24.6 | 1.45 | 1.17, 1.81 | 6.27 | 2.56, 9.99 | 1.26 | 1.09, 1.45 | <.001 | 3.28 | 1.13, 5.44 | <.001 |
| Prior engagement in psychiatric outpatient services | |||||||||||||
| Active (past month) | 9,108 | 1,430 | 15.7 | ref | ref | ref | ref | ||||||
| Recent (past 12 months but not past month) | 3,800 | 823 | 21.7 | 1.48 | 1.18, 1.87 | 5.96 | 2.39, 9.53 | 1.35 | 1.06, 1.71 | .001 | 3.86 | .72, .71 | .01 |
| None in past 12 months | 5,277 | 1,429 | 27.1 | 1.99 | 1.56, 2.54 | 11.38 | 7.08, 15.68 | 1.90 | 1.54, 2.35 | <.001 | 9.35 | 6.27, 12.44 | <.001 |
| Hospital Charcteristics | |||||||||||||
| Number of hospital beds | |||||||||||||
| Small: less than 100 | 768 | 96 | 12.5 | ref | ref | ref | ref | ||||||
| Medium: 100–499 | 9680 | 1756 | 18.1 | 1.55 | .61, 3.94 | 5.64 | −4.96, 16.24 | 1.24 | .59, 2.61 | .46 | 2.71 | −6.01, 11.43 | .42 |
| Large: 500 or more | 7737 | 1830 | 23.7 | 2.17 | .84, 5.61 | 11.15 | −.31, 22.61 | 1.35 | .52, 3.49 | .42 | 3.88 | −7.90, 15.66 | .39 |
| Hospital ownership | |||||||||||||
| Public | 5035 | 1137 | 22.58 | ref | ref | ref | ref | ||||||
| Private not-for-profit | 11334 | 2198 | 19.39 | .82 | .48, 1.43 | −3.19 | −12.51, 6.13 | 1.03 | .57, 1.83 | .91 | .34 | −7.47. 8.15 | .91 |
| Private for-profit | 1816 | 347 | 19.11 | .81 | .39, 1.69 | −3.47 | −15.45, 8.50 | 1.28 | .52, 3.14 | .48 | 3.63 | −10.24, 17.50 | .50 |
| Psychiatric discharges that were Medicaid, % | |||||||||||||
| Low: less than 49% | 3537 | 654 | 18.5 | ref | ref | ref | ref | ||||||
| Medium: 49–71% | 9231 | 1507 | 16.3 | .86 | .49, 1.51 | −2.16 | −10.37, 6.04 | 1.11 | .78, 1.57 | .46 | 1.3 | −3.11, 5.70 | .45 |
| High: over 71% | 5417 | 1521 | 28.1 | 1.72 | .97, 3.06 | 9.59 | −.42, 19.60 | 1.38 | .79, 2.42 | .14 | 4.51 | −3.33, 12.36 | .14 |
| Hospital provides outpatient psychiatric services | |||||||||||||
| No | 2459 | 331 | 13.5 | ref | ref | ref | ref | ||||||
| Yes | 15726 | 3351 | 21.3 | 1.74 | .86, 3.51 | 7.85 | −.79, 16.49 | 1.03 | .66, 1.61 | .85 | .45 | −5.55, 6.44 | .85 |
| Teaching hospital | |||||||||||||
| No | 3394 | 440 | 13.0 | ref | ref | ref | ref | ||||||
| Yes | 14791 | 3242 | 21.9 | 1.88 | .85, 4.16 | 8.95 | −.46, 18.37 | 1.14 | .62, 2.10 | .58 | 1.75 | −6.26, 9.76 | .57 |
| Psychiatric discharges with substance use disorder diagnosis | |||||||||||||
| Low: less than 34% | 4260 | 789 | 18.52 | ref | ref | ref | ref | ||||||
| Medium: 34–60% | 10154 | 2243 | 22.09 | 1.25 | .67, 2.31 | 3.57 | −6.04, 13.17 | .93 | .57, 1.50 | .69 | −1.03 | −7.75, 5.70 | .69 |
| High: over 60% | 3771 | 650 | 17.24 | .92 | .44, 1.92 | −1.28 | −12.20, 9.63 | .99 | .55, 1.78 | .96 | −.13 | −8.46, 8.19 | .96 |
| Psychiatric population with 2 or more psychiatric discharges | |||||||||||||
| Low: less than 24.5% | 4050 | 511 | 12.62 | ref | ref | ref | ref | ||||||
| Medium: 24.5–35% | 8905 | 1778 | 19.97 | 1.73 | .84, 3.57 | 7.35 | −1.44, 16.14 | .94 | .48, 1.82 | .79 | −.92 | −10.37. 8.52 | .80 |
| High: over 35% | 5230 | 1393 | 26.63 | 2.51 | 1.20, 5.27 | 14.02 | 4.14, 23.89 | .93 | .37, 2.35 | .84 | −1.02 | −13.96, 11.92 | .84 |
| System Characteristics | |||||||||||||
| Behavioral Health Organization | |||||||||||||
| Western | 2577 | 224 | 8.7 | ref | ref | ref | ref | ||||||
| Central | 2534 | 171 | 6.6 | .76 | .34, 1.71 | −1.94 | −7.31, 3.42 | 1.30 | .54, 3.12 | .44 | 1.89 | −4.70, 8.48 | .46 |
| Hudson River | 4594 | 1151 | 25.1 | 3.51 | 2.19, 5.64 | 16.36 | 9.59, 23.14 | 5.01 | 2.43, 10.32 | <.001 | 20.24 | 12.27, 28.21 | <.001 |
| NYC | 6736 | 1894 | 28.1 | 4.11 | 2.65, 6.37 | 19.43 | 13.15, 25.7 | 3.80 | 1.86, 7.77 | <.001 | 15.14 | 7.52, 22.77 | <.001 |
| Long Island | 1744 | 242 | 13.9 | 1.69 | 1.07, 2.67 | 5.18 | .63, 9.73 | 1.85 | .89, 3.87 | .03 | 5.19 | −1.38, 11.75 | .04 |
| County population in poverty | |||||||||||||
| Low: less than 15% | 5887 | 1102 | 18.72 | ref | ref | ref | ref | ||||||
| Medium: 15–19% | 6867 | 1305 | 19.00 | 1.02 | .68, 1.52 | .28 | −5.89, 6.46 | .97 | .62, 1.53 | .87 | −0.42 | −7.15, 6.31 | .87 |
| High: 20% or higher | 5262 | 1222 | 23.22 | 1.31 | .90 – 1.92 | 4.50 | −1.71, 10.71 | .69 | .36, 1.31 | .13 | −4.92 | −13.41, 3.56 | .14 |
| Mental health workers per 100k | |||||||||||||
| Low: less than 67 | 1391 | 132 | 9.49 | ref | ref | ref | ref | ||||||
| Medium: 67 to 166 | 10219 | 2078 | 20.33 | 2.43 | 1.45, 4.08 | 10.85 | 5.05, 16.64 | .89 | .54, 1.47 | .54 | −1.74 | −9.26, 5.78 | .55 |
| High: 167 or more | 6406 | 1419 | 22.15 | 2.71 | 1.69, 4.35 | 12.66 | 7.75, 17.58 | .81 | .46, 1.43 | .33 | −3.03 | −11.38, 5.32 | .35 |
| Urban/rural classification | |||||||||||||
| Medium metro | 2129 | 257 | 12.1 | ref | ref | ref | ref | ||||||
| Large central metro | 9797 | 2427 | 24.8 | 2.4 | 1.30, 4.44 | 12.7 | 5.11, 20.29 | 2.05 | .92, 4.56 | .02 | 8.89 | .45, 17.33 | .01 |
| Large fringe metro | 3188 | 646 | 20.3 | 1.85 | .99, 3.46 | 8.19 | .74, 15.65 | 1.74 | .89, 3.41 | .03 | 6.43 | −.60, 13.46 | .02 |
| Small metro | 1052 | 142 | 13.5 | 1.14 | .45, 2.84 | 1.43 | −8.96, 11.82 | 1.36 | .71, 2.62 | .23 | 3.27 | −3.53, 10.07 | .23 |
| Micropolitan | 1438 | 108 | 7.5 | .59 | .30, 1.15 | −4.56 | −11.01, 1.88 | 1.19 | .59, 2.38 | .52 | 1.76 | −5.13, 8.65 | .51 |
| Noncore | 412 | 49 | 11.9 | .98 | .45, 2.14 | −.18 | −8.38, 8.02 | 1.16 | .53, 2.53 | .63 | 1.44 | −6.35, 9.24 | .63 |