Thursday, June 10, 2021

N.Y. State Program for First-Episode Psychosis Reduces Hospitalization, ER Use

Medicaid patients in New York state with a first episode of psychosis visited the emergency room and hospital significantly less after enrollment in the coordinated specialty care program OnTrackNY than prior to enrollment, according to a report in Psychiatric Services in Advance.

OnTrackNY is New York state’s early intervention program for individuals aged 16 to 30 who have experienced nonaffective psychosis for less than two years. With 23 sites throughout the state, OnTrackNY offers psychotherapy, medication management, family education and support, case management, and work and education support, depending on each individual’s needs and preferences. The Center for Practice Innovations at Columbia University, New York State Psychiatric Institute, and the New York State Office of Mental Health are partners in OnTrackNY.

“Notably, hospitalization rates have been shown to decrease during the first three months after OnTrackNY enrollment and remain relatively steady thereafter; the present study showed that these rates did not significantly increase during the first six months after discharge,” wrote Jennifer Humensky, Ph.D., of Columbia University Department of Psychiatry and New York State Psychiatric Institute and colleagues.

They compared rates of hospitalization and emergency room (ER) visits for 138 patients who were enrolled in OnTrackNY for at least six months and covered by Medicaid in the six months prior to program entry, the six months prior to OnTrackNY discharge, and the six months after OnTrackNY discharge.

In the pre-enrollment period, participants had an average of 1.45 ER visits, 0.80 inpatient visits, and 12.88 inpatient days. This use decreased to an average of 0.88 ER visits, 0.26 inpatient visits, and 3.7 inpatient days in the six months before discharge from OnTrackNY. Six months after discharge from ONTrackNY, the rates had not significantly changed: Patients had an average of 0.83 ER visits, 0.3 inpatient visits, and 4.9 inpatient days.

“Although more research is needed, particularly of larger populations and over a longer time frame, this study provides an initial indication that decreases in hospitalization and ER usage are maintained and do not significantly increase in the first six months after discharge from OnTrackNY,” the researchers concluded.

For related information, see the Psychiatric News article “Evidence Supporting Early Psychosis Treatment Grows as Programs Gain Ground in Communities.”

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