Telepsychiatry Program Increases Rate of ED Discharges to Home

Patients with psychiatric symptoms who received care in the emergency department (ED) were discharged home, rather than transferred to a psychiatric facility, more often when the North Carolina Statewide Telepsychiatry Program was available, according to a study published online in the journal Psychiatric Services.

“The number of patients seeking treatment in emergency departments for mental health reasons is rising, and these patients are often kept in the emergency department until they can be treated or discharged, leading to overcrowding,” researchers wrote. “Telepsychiatry may alleviate overcrowding by increasing the rate of discharges home.” 

To investigate the impact of the North Carolina Statewide Telepsychiatry Program, researchers looked at ED discharge records for 86,931 patients with psychiatric symptoms. 

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Among patients with a length of stay longer than 2 days, 62% were discharged home and 29% were transferred to a psychiatric facility when the statewide telepsychiatry program was available, according to the study, compared with 43% discharged home and 46% transferred to a psychiatric facility when it was not available.

The increase in home discharges and decrease in psychiatric facility transfers with telepsychiatry program availability were statistically significant.

Meanwhile, among patients with a length of stay (LOS) of 1 or 2 days, 77% were discharged home and 15.4% were transferred to a psychiatric facility when the telepsychiatry program was available, compared with 74.2% discharged home and 13.9% to a psychiatric facility when it was not available.

“These results show that telepsychiatry clearly has utility for patients with psychiatric symptoms in the ED for longer periods and whose conditions are presumably more complex,” researchers wrote. “However, the results also call for more study of the utility of telepsychiatry in the ED for patients with less complex chief symptoms or with a shorter LOS.”

—Jolynn Tumolo

Reference

Kothadia RJ, Jones K, Saeed SA, Torres MJ. The impact of the North Carolina Statewide Telepsychiatry Program (NC-STeP) on patients' dispositions from emergency departments. Psychiatric Services. 2020 October 6;[Epub ahead of print].