caa a22 4500 469067683 CHVBK 20180323132913.0 cr unu---uuuuu 170328e19920601xx s 000 0 eng 10.1007/BF02521318 doi (NATIONALLICENCE)springer-10.1007/BF02521318 Multifacility utilization by the chronically mentally ill in the department of veterans affairs [Elektronische Daten] [Paul Durance, Teresa Gibson, Mary Davis-Sacks, Rick Homan] The objectives of this research are (1) to quantify the multifacility utilization patterns ("shared care”) for a selected subset of patients with a chronic mental disorder, (2) to examine the patient characteristics correlated with several observed utilization patterns, and (3) to determine facility groups through cluster analysis, based on multifacility readmissions. Patients were identified from the VA's hospital discharge abstract system based on a diagnosis of schizophrenia in any discharge during the two-year study period. All discharges for this cohort during the period were analyzed. Essentially, three different groups of patients from this cohort were found. The vast majority have one or two hospitalizations and in the process are seen at one or maybe two facilities. However, two small minorities are hospitalized many times. One small group confines these hospitalizations to relatively few facilities while the other travels from facility to facility around the country. These two groups present very different clinical management problems from each other as well as from the majority. Since the distribution of travel distance between facilities remained similar for all types of patients (median distance was about 120 miles), facilities were clustered based on the number of linkages they shared. By use of six different measures of the disjointedness of shared care, clustering produced a reasonable number of meaningful groups which account for a majority of possibly uncoordinated shared care. We feel that these results and this approach can be useful for administrators, policymakers, and researchers. By looking simultaneously at the utilization patterns of its clients and their characteristics (e.g., age) as well as the utilization patterns within groups of facilities, any multifacility health system can characterize its shared care and identify those clients and facilities most in need of intervention, resources, and future study. Association of Mental Health Administrators, 1992 Durance Paul Research Health Science Specialist, Department of Veterans Affairs, Great Lakes HSR&D Field Program, P. O. Box 130170, 48113-0170, Ann Arbor, MI aut Gibson Teresa MEDSTAT Systems, Inc., Ann Arbor, Mich aut Davis-Sacks Mary College of Literature, Science and the Arts, University of Michigan, Ann Arbor, Mich aut Homan Rick Research Health Science Specialist, Department of Veterans Affairs, Great Lakes HSR&D Field Program, P. O. Box 130170, 48113-0170, Ann Arbor, MI aut The journal of mental health administration Springer-Verlag 19/2(1992-06-01), 178-194 0092-8623 19:2<178 1992 19 11414 https://doi.org/10.1007/BF02521318 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/BF02521318 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Durance Paul Research Health Science Specialist, Department of Veterans Affairs, Great Lakes HSR&D Field Program, P. O. Box 130170, 48113-0170, Ann Arbor, MI aut NATIONALLICENCE 700 1- Gibson Teresa MEDSTAT Systems, Inc., Ann Arbor, Mich aut NATIONALLICENCE 700 1- Davis-Sacks Mary College of Literature, Science and the Arts, University of Michigan, Ann Arbor, Mich aut NATIONALLICENCE 700 1- Homan Rick Research Health Science Specialist, Department of Veterans Affairs, Great Lakes HSR&D Field Program, P. O. Box 130170, 48113-0170, Ann Arbor, MI aut NATIONALLICENCE 773 0- The journal of mental health administration Springer-Verlag 19/2(1992-06-01), 178-194 0092-8623 19:2<178 1992 19 11414 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer