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KMID : 1118520230200121133
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Psychiatry Investigation
2023 Volume.20 No. 12 p.1133 ~ p.1141
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Effectiveness of a Community-Based Intensive Case Management Model on Reducing Hospitalization for People With Severe Mental Illness in Seoul
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Sohn Jee-Hoon
Cho Sung-Joon
Lee Hae-Woo
Kim Hyun
Lee Seung-Yeon
Park Yoo-Mi
Seo Hwo-Yeon
Kim Eun-Soo
Park Jee-Eun
Hahm Bong-Jin
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Abstract
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Objective: To overcome the limited effectiveness of standard case management services, the Seoul Intensive Case Management program (S-ICM) for patients with serious mental illnesses was introduced in 2017. This study aimed to evaluate its effectiveness in reducing the length of hospital stay.
Methods : Monitoring data from April 2019 to March 2020 were retrieved from the Seoul Mental Health Welfare Center. A total of 759 participants with serious mental illnesses were included. The average length of admission per month was compared between the pre-ICM (previous year) and during-ICM periods. For post-ICM observation subgroup, average length of admission per month was compared between pre-ICM, during-ICM, and post-ICM periods. To determine the relative contributions of risk factors for during-ICM and post-ICM admission, multivariate logistic regression analyses were performed.
Results: The average admission stay for pre-ICM period was significantly longer than that for during-ICM period (1.47 vs. 0.26 days). Among the predictors for during-ICM admission, pre-ICM psychiatric admission was the most important risk factor, followed by medical aid beneficiary and suicidal behavior. In the subgroup analysis of the post-ICM observation period, the pre-ICM, during-ICM, and post-ICM average admission stays were 1.45, 0.29, and 0.57 days/month, respectively. There was a significant difference in the average length of stay between the pre-ICM and during-ICM periods and between the pre-ICM and post-ICM periods. Post-ICM admission risks included pre-ICM admission, S-ICM duration <3 months, and chronic unstable symptoms.
Conclusion: The results suggest that the S-ICM effectively reduces psychiatric hospitalization duration, at least over a short-term period.
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KEYWORD
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Community mental health services, Hospital, Length of stay, Mental illness
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