At least 134 patients
every day could have received care in a more appropriate setting
ST.
PAUL – A new study by the Minnesota Hospital Association (MHA) found that nearly
one in five days mental health patients spend admitted to inpatient community
hospital psychiatric units is potentially avoidable. “Potentially avoidable
days” are days that mental health patients spent admitted to the hospital when
they would more appropriately have been treated in a different care setting.
The
first-of-its-kind study tracked de-identified mental health patients admitted
to inpatient psychiatric units at 20 participating hospitals and health systems
throughout Minnesota between March 15 and April 30, 2016. Of the 32,520 total
mental health bed days in all participating hospitals, 6,052 – or 19 percent –
were identified as potentially avoidable. This number translates to approximately 48,000
potentially avoidable days in a year in just 20 of Minnesota’s 147 hospitals.
While
some individual hospitals or health systems maintained their own data and
others had anecdotal information, MHA’s research was a deliberate process to
identify and quantify barriers to accessing mental health care in Minnesota. No
current robust statewide data on potentially avoidable days previously existed.
“Mental
illnesses affect us all. Behind these numbers are patients and families who are
not getting the care they need in the right place at the right time,” said Dr.
Rahul Koranne, MHA’s chief medical officer. “On any given day, 134 patients across
these 20 hospitals could have been more appropriately served in a different
care setting. Bottlenecks exist throughout the mental health care delivery
system, resulting in patients remaining in community hospitals for extended
periods of time – which in turn means that hospital beds are unavailable to
others in the community experiencing mental health crises.”
The
study identified 26 reasons why potentially avoidable days occurred. These
reasons can be grouped into two main categories:
- 64
percent of potentially avoidable days occurred due to lack of space in a
state-run mental health hospital, residential treatment center, nursing home,
group home, chemical dependency treatment service or other setting.
- 30
percent of potentially avoidable days occurred due to social service or government
agency delays, including identifying an appropriate treatment location for a
patient, completing agency approvals or other administrative processes or
resolving legal proceedings involving the patient.
The
most frequently cited reasons for potentially avoidable days were lack of beds
at state-operated Community Behavioral Health Hospitals (CBHHs), chemical
dependency treatment facilities, Intensive Residential Treatment Services
(IRTS) and Anoka Metro Regional Treatment Center (AMRTC).
“Minnesota’s
hospitals and health systems believe every Minnesotan deserves access to safe,
effective and affordable care to treat mental illnesses. Our study provides better
data to inform regional and statewide conversations about mental health service
delivery and the state resources needed to effectively serve Minnesota
communities,” said Koranne. “This is a shared community responsibility.
Hospitals and health systems are committed to working with stakeholders
including the state, the Department of Human Services, counties and other
community partners like mental health advocates and local law enforcement to
make a difference for patients and families.”
The
following 20 hospitals and health systems participated in the study:
- Allina
Health – Abbott Northwestern Hospital
- Allina
Health – Cambridge Medical Center
- Allina
Health – Mercy Hospital
- Allina
Health – New Ulm Medical Center
- Allina
Health – Owatonna Hospital
- Allina
Health – United Hospital
- Allina
Health – Unity Hospital
- CentraCare
Health – St. Cloud Hospital
- Essentia
Health – Duluth
- Essentia
Health – St. Joseph’s Medical Center
- HealthEast
Care System – St. Joseph’s Hospital
- Hennepin
County Medical Center
- Hutchinson
Health
- Mayo
Clinic Health System in Albert Lea and Austin (Austin)
- Mayo
Clinic Health System in Mankato
- Mayo
Clinic Hospital - Rochester, Saint Marys Campus
- North
Memorial Medical Center
- PrairieCare
Brooklyn Park
- Regions
Hospital
- St.
Luke’s Hospital
The
full report is available on MHA’s website: www.mnhospitals.org/policy-advocacy/priority-issues/mental-health.
The
Minnesota Hospital Association represents 137 hospitals and health systems,
which provide quality care for their patients and meet the needs of their
communities.
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