The Effects of an Enhanced Primary Care Model for Patients with Serious Mental Illness on Emergency Department Utilization

Community Ment Health J. 2020 Oct;56(7):1311-1317. doi: 10.1007/s10597-020-00645-0. Epub 2020 May 28.

Abstract

Patients with Serious Mental Illness (SMI) have high rates of emergency department visits and high premature mortality rates, often due to poor primary care. A model of enhanced primary care services integrated in a behavioral health location is being implemented and studied at the UNC WakeBrook Primary Care Center (UNCWPC). This research was conducted as a retrospective cohort study. ED Visit Utilization before and after establishing care at UNCWPC were calculated for a cohort and a subset of patients. There was a decrease in ED utilization after years 3-4 of enrollment for physical health complaints for the overall cohort (n = 101), from 3.23 to 1.83 visits/person/year, and for patients with multiple physical comorbidities (n = 50), from 4.04 to 2.48 visits/person/year. This study indicated that an enhanced model of primary care can help decrease ED utilization for primary care conditions. The decline was not seen until the patients were well-established.

Keywords: Bipolar disorder; Emergency Department Utilization; Mental health; Physical health; Schizophrenia; Serious mental illness.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Emergency Service, Hospital
  • Hospitalization*
  • Humans
  • Mental Disorders* / epidemiology
  • Mental Disorders* / therapy
  • Primary Health Care
  • Retrospective Studies