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Suicide risk among veterans of military service. Reduced Mortality Among Department of Veterans Affairs Patients With Schizophrenia or Bipolar Disorder Lost to Follow-up and Engaged in Active Outreach to Return for Care.

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Titre :	Suicide risk among veterans of military service. Reduced Mortality Among Department of Veterans Affairs Patients With Schizophrenia or Bipolar Disorder Lost to Follow-up and Engaged in Active Outreach to Return for Care. (2012)
Auteurs :	Chester-L DAVIS ; Frederic-C BLOW ; Edward HUYCKE ; Amy-M KILBOURNE ; Robert LANGBERG ; David LYLE ; MCKEON (Richard) : USA. Center for Health Services. Suicide Prevention Branch. Substance Abuse and Mental Health Services Administration. Rockville. MD. ; Yancy PHILLIPS ; John-R PIERCE ; POWER (Akathryn) : USA. Center for Mental Health Services. Suicide Prevention Branch. Substance Abuse and Mental Health Services Administration. Rockville. MD. ; Stephanie VISNIC ; Bernard-M WINKEL ; Veterans Health Administration. Office of the Medical Inspector. Washington. DC. USA ; Veterans Health Administration. Serious Mental Illness Resource and Evaluation Center. Center for Clinical Management Research. Ann Arbor. MI. USA
Type de document :	Article
Dans :	American journal of public health (vol. 102, 2012)
Pagination :	S74-S79
Langues:	Anglais
Mots-clés :	Schizophrénie ; Epidémiologie ; Mortalité ; Assurance maladie ; Système santé ; Homme ; Malade ; Trouble bipolaire ; Soins ; Amérique ; Psychose ; Amérique du Nord
Résumé :	[BDSP. Notice produite par INIST-CNRS R0x9lsEs. Diffusion soumise à autorisation]. Objectives. We determined whether contacting Department of Veterans Affairs (VA) patients with schizophrenia or bipolar disorders (serious mental illness [SMI]) who had dropped out of care for prolonged periods resulted in reengagement with VA services and decreased mortality. Methods. We developed a list of patients with SMI who were last treated in fiscal years 2005 to 2006, and were lost to follow-up care for at least 1 year. VA medical centers used our list to contact patients and schedule appointments. Additional VA administrative data on patient utilization and mortality through May 2009 were analyzed. Results. About 72 % (2375 of 3306) of the patients who VA staff attempted to contact returned for VA care. The mortality rate of returning patients was significantly lower than that for patients not returning (0.5 % vs 3.9 % ; adjusted odds ratio =5.8 ; P <. 001), after demographic and clinical factors were controlled. Conclusions. The mortality rate for returning patients with SMI was almost 6 times less than for those who did not return for medical care. Proactive outreach might result in patients returning to care and should be implemented to reengage this vulnerable group.