Date of Award

10-2025

Document Type

Dissertation

Degree Name

Doctor of Psychology (PsyD)

Department

Psychology

First Advisor

Patrick J. Aragon

Second Advisor

Julie S. Costopoulos

Third Advisor

Jonathan K. Fernand

Abstract

Psychiatric readmissions remain a persistent challenge in mental health care, often reflecting gaps in continuity of treatment following discharge. The Agency for Healthcare Research and Quality (2019) indicated that a key component in preventing inpatient readmission is adequate outpatient care following discharge. Moreover, early attendance in outpatient follow-up visits is associated with improved patient outcomes (Boston Medical Center, 2022). Various predictors are associated with engagement in outpatient services, such as age, medication compliance, and socioeconomic variables (Carson et al., 2014; Li et al., 2005; Marino et al., 2016; Stubbs et al., 2024).

The present study sought to determine whether psychiatric readmissions occurred after follow-up attendance, and whether older age, medication adherence, and higher socioeconomic status were factors for greater engagement in outpatient services. Medical records of 18,323 patients with demographic data, dates of inpatient admissions, discharges, and readmissions, if applicable, were documented. Dates of outpatient appointments and the type of outpatient services were also included.

A chi-square test of independence found a significant association between follow-up attendance within 30 days of discharge and subsequent readmission within 90 days, indicating that patients who did not attend at least one outpatient appointment within 30 days of discharge were readmitted within 90 days. A significant difference using a chi-square test of independence was not found between older age and follow-up attendance, suggesting that patients aged 64 and younger engaged in more outpatient services. An independent-samples t-test comparing outpatient attendance between patients who attended their first medication appointment and those who did not revealed no significant difference; medication-compliant patients did not demonstrate greater engagement in follow-ups. It was proposed that patients from higher socioeconomic backgrounds would attend more outpatient services than those from lower socioeconomic backgrounds. However, due to the absence of data, including income and occupation, this association was undetermined. Future research should account for inconsistent documentation of patient data, incorporate a comprehensive assessment of socioeconomic status, and include objective measures of medication adherence to obtain an accurate understanding of patient engagement after discharge.

Download

Share

COinS