The Impact of NC Statewide Telepsychiatry Program (NC-STeP) on Cost Savings by Reducing Unnecessary Psychiatric Hospitalizations During a 6½ Year Period.

Objective: To study the impact of the North Carolina Statewide Telepsychiatry Program in reducing unnecessary psychiatric hospitalizations and cost savings during a 6½ year period.

Methods: Patient encounter data was extracted from the NC-STeP database that captured records of 19,383 patients who received services over a 6½ -years' period. We analyzed the data to calculate the total number of patient encounters, the number of encounters with an IVC, and the number of encounters with an IVC that was overturned. For encounters with an overturned IVC, we also determined the patient discharge disposition. We estimated the cost of a typical mental health hospitalization to measure the savings generated by the overturned IVCs in the NC-STeP program.

Results: Over the 6½ year period there were 19,383 NC-STeP patient encounters at partner hospital emergency departments. There were 13,537 encounters where the patient had an IVC in place during the ED stay, and 4,627 where the IVC was overturned (34 %). For patients where there was an IVC that was overturned, 85.9 % of those patients were ultimately discharged home. Using the "three-way bed" cost estimate of $ 4,500 for each overturned IVC, the cost savings generated by the NC-STeP program from November 2013 to June 2020 were $ 20,821,500.

Conclusions: Telepsychiatry consultation services in the emergency departments can decrease unnecessary psychiatric hospitalizations and contribute to significant cost savings to the healthcare system and society and improve the outcomes for patients and families by decreasing financial burden and stress associated with a hospital stay.