Predictors of Length of Hospitalization and Impact on Early Readmission for Mental Disorders.

Length of hospitalization, if inappropriate to patient needs, may be associated with early readmission, reflecting sub-optimal hospital treatment, and translating difficulties to access outpatient care after discharge. This study identified predictors of brief-stay (1-6 days), mid-stay (7-30 days) or long-stay (≥31 days) hospitalization, and evaluated how lengths of hospital stay impacted on early readmission (within 30 days) among 3729 patients with mental disorders (MD) or substance-related disorders (SRD). This five-year cohort study used medical administrative databases and multinomial logistic regression.

The Impact of 90-day Physician Follow-up Care on the Risk of Readmission Following a Psychiatric Hospitalization.

Aims: This study measures the impact of 90-day physician follow-up care after psychiatric hospitalization among 3,311 adults and youth, with risk of subsequent readmission within six months.

Methods: A 5-year investigation was conducted based on Quebec (Canada) medical administrative databases. Cox proportional-hazards regression was performed, with 90-day follow-up care as the main independent variable, controlling for various sociodemographic, clinical, and other service use variables.

Investigating characteristics of patients with mental disorders to predict out-patient physician follow-up within 30 days of emergency department discharge.

Background: Prompt follow-up at emergency department discharge is a key indicator of healthcare quality and patient recovery. To improve services, better knowledge of predictors for out-patient physician follow-up within 30 days after discharge is needed.

Aims: We investigated clinical and sociodemographic characteristics and service use to predict patients with mental disorders with or without physician follow-up after emergency department use.

Impact of Co-occurring Mental Disorders and Chronic Physical Illnesses on Frequency of Emergency Department Use and Hospitalization for Mental Health Reasons.

Patients with mental disorders (MD) are at high risk for a wide range of chronic physical illnesses (CPI), often resulting in greater use of acute care services. This study estimated risk of emergency department (ED) use and hospitalization for mental health (MH) reasons among 678 patients with MD and CPI compared to 1,999 patients with MD only. Patients visiting one of six Quebec (Canada) ED for MH reasons and at onset of a MD in 2014-15 (index year) were included.

Predictors of Recurrent High Emergency Department Use among Patients with Mental Disorders.

Few studies have examined predictors of recurrent high ED use. This study assessed predictors of recurrent high ED use over two and three consecutive years, compared with high one-year ED use. This five-year longitudinal study is based on a cohort of 3121 patients who visited one of six Quebec (Canada) ED at least three times in 2014-2015.

Factors Related to 30-day Readmission following Hospitalization for Any Medical Reason among Patients with Mental Disorders: Facteurs liés à la réhospitalisation à 30 jours suivant une hospitalisation pour une raison médicale chez des patients souffrant de troubles mentaux.

Objective: This study evaluated the contributions of clinical, sociodemographic, and service use variables to the risk of early readmission, defined as readmission within 30 days of discharge following hospitalization for any medical reason (mental or physical illnesses), among patients with mental disorders in Quebec (Canada).

Methods: In this longitudinal study, 2,954 hospitalized patients who had visited 1 of 6 Quebec emergency departments (ED) in 2014 to 2015 (index year) were identified through clinical administrative databanks. The first hospitalization was considered that may have occurred at any Quebec hospital.

Risk factors of hospitalization for any medical condition among patients with prior emergency department visits for mental health conditions.

Background: This longitudinal study identified risk factors for frequency of hospitalization among patients with any medical condition who had previously visited one of six Quebec (Canada) emergency departments (ED) at least once for mental health (MH) conditions as the primary diagnosis.

Methods: Records of n = 11,367 patients were investigated using administrative databanks (2012-13/2014-15). Hospitalization rates in the 12 months after a first ED visit in 2014-15 were categorized as no hospitalizations (0 times), moderate hospitalizations (1-2 times), and frequent hospitalizations (3+ times).

Variables associated with low, moderate and high emergency department use among patients with substance-related disorders.

Aims: This study identified factors associated with frequency of emergency department (ED) use for medical reasons among patients with substance-related disorders (SRD) in Quebec (Canada) for 2014-15.

Methods: Participants (n = 4731) were categorized as: 1) low (1 visit/year), 2) moderate (2 visits/year), and 3) high (3+ visits/year) ED users. Independent variables included predisposing, enabling and needs factors based on the Andersen Behavioral Model.

Satisfaction with health and community services among homeless and formerly homeless individuals in Quebec, Canada.

User satisfaction is a crucial quality indicator in health service provision. Few studies have measured user satisfaction among homeless and formerly homeless individuals, despite the high prevalence of mental health disorders (MHD) in this population. The purpose of this study was to assess overall satisfaction among 455 homeless and formerly homeless individuals who were receiving health and community services, and to identify factors associated with user satisfaction.

Cognition and drug adherence to oral hypoglycemic and antihypertensive agents in older adults.

Chronic disorders such as diabetes mellitus type II and hypertension have been associated with cognitive decline in older adults. It is unclear whether adherence to antihypertensive and oral hypoglycemic agents impact cognitive health. The objectives are to study the association between adherence to antihypertensive and oral hypoglycemic agents and cognitive status in community-living older adults.

Profiles of Quality of Life in a Homeless Population.

Quality of life (QOL) is a key indicator in mental health planning, program evaluation, and evaluation of patient outcomes. Yet few studies have focused on QOL in homeless populations. More specifically, research has yet to identify profiles of homeless individuals based on their QOL using cluster analysis.

Correction to: Sociodemographic Variation in Increasing Needs for Mental Health Services among Canadian Adults from 2002 to 2012.

The original version of this article unfortunately contained a mistake.

Sociodemographic Variation in Increasing Needs for Mental Health Services among Canadian Adults from 2002 to 2012.

Background: Numerous countries have developed public health programs and restructured mental health service delivery to alleviate the growing burden of mental illness. These initiatives address increased needs for mental health services, as individuals become better-informed and more open-minded concerning psychiatric symptoms and mental health care. This study aimed to investigate how needs for mental health services have increased among Canadian adults in recent years, and how needs may differ across different sociodemographic groups.

Impact of depression and anxiety disorders on adherence to oral hypoglycemics in older adults with diabetes mellitus in Canada.

The prevalence of diabetes mellitus is increasing in Canada, and nonadherence to oral hypoglycemics is a common problem among older adults. This study aims to document the impact of depression and anxiety disorders on adherence to oral hypoglycemics in older adults with diabetes mellitus. Data used in this study came from the longitudinal Quebec survey on senior's health (Enquête sur la Santé des Ainés), using a representative sample of 2811 older adults aged 65 and over.

Impact of Mental Disorders on the Association Between Adherence to Antihypertensive Agents and All-Cause Healthcare Costs.

Depression and anxiety are factors associated with poor adherence to medications that lead to increased healthcare costs. The authors hypothesize that these conditions will moderate the association between adherence and healthcare costs. The aim was to examine the healthcare costs associated with adherence to antihypertensive agents in the elderly with and without depression and anxiety.

Adherence to Oral Antihyperglycemic Agents Among Older Adults With Mental Disorders and Its Effect on Health Care Costs, Quebec, Canada, 2005-2008.

Introduction: Nonadherence to oral antihyperglycemic agents (OHAs) leads to an increase in use of health care resources and overall expenditures due to type 2 diabetes and its complications. People with type 2 diabetes are almost twice as likely to have anxiety and depression as the general population. Our aim was to examine health care costs associated with adherence to OHAs and the effect of depression and anxiety disorders on these in older adults with type 2 diabetes.

The excess healthcare costs associated with depression and anxiety in elderly living in the community.

Objective: To estimate the excess healthcare costs attributable to depression and anxiety in a public managed care system.

Methods: The data were retained from a population-based health survey on 2,494 community-dwelling older adults age 65 years or more participating in the ESA (Étude sur la Santé des Aînés) study. Depression and anxiety were assessed using Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) criteria and measured at two time points 1 year apart.

[Episodes of care: a concept in public health].

This paper presents a revision of the literature on the definition of episodes of care, which emerged as a concept in health services research during the 1960s. Episodes of care have been described from three different perspectives: that of the patient (episode of indisposition); the care provider (episode of illness); and the financial sponsor (episode of care). The main scope of this study is to present a review of the literature on the operational definition of episode of care.

Association between depressive and anxiety disorders and adherence to antihypertensive medication in community-living elderly adults.

Objectives: To identify the determinants of antihypertensive medication adherence in community-living elderly adults.

Design: Longitudinal observational study.

Setting: Population-based health survey in the province of Quebec, Canada.

Correlates of potentially inappropriate prescriptions of benzodiazepines among older adults: results from the ESA study.

ESA study data were paired with Quebec medical and pharmaceutical services records to document potentially inappropriate benzodiazepines (Bzs) prescriptions among community-dwelling adults aged 65 and older. Results indicate that 32 per cent of respondents took a mean daily dose of 6.1 mg of equivalent diazepam for, on average, 205 days per year.