Long-term Efficacy of Continuity-of-care Treatment Model for Severe Mental Illness Patients

Background: Despite its significance, ensuring continuity-of-care demands substantial resources, which might not be readily accessible in many public healthcare systems. Studies indicate that continuity-of-care remains uncertain in numerous healthcare systems.

Aims: This study aimed to assess the effectiveness of a continuity-of-care model for patients with severe mental illness (SMI), providing seamless treatment from discharge from a closed word to subsequent psychiatric, psychological and rehabilitation services.

Methods: Data from patients discharged before (January 1st to December 31st, 2018) and after (June 1st, 2021, to May 31st, 2022) full implementation of the model were analyzed and compared in terms of average duration of hospitalization, emergency room visits within 90 days of discharge, rehospitalization rate within one-year post-discharge, and initiation of rehabilitation process.

Results: In the post-implementation period (n=482), compared to the pre-implementation period (n=403), the average admission time significantly decreased from 30.51±29.72 days to 26.77±27.89 days (p=0.029). Emergency room visits within 90 days following discharge decreased from 38.70% to 26.35% of discharged patients (p<0.001). The rate of readmission decreased from 50.9% to 44.0% (p=0.041) for once and from 28.3% to 22.0% (p=0.032) for twice in the year following discharge. Additionally, the proportion of patients entering formal rehabilitation increased from 7.94% to 12.03% (p=0.044).

Conclusions: This study highlights the effectiveness of a continuity-of-care model spearheaded by senior psychiatrists and involving paramedical personnel. These findings underscore the significant potential of the model to substantially enhance mental health services and outcomes. Moreover, they emphasize its relevance for patients, clinicians, and policymakers.