Outpatient follow-up after psychiatric hospitalization for depression and later readmission and treatment adequacy

OBJECTIVE: The study evaluated whether timely postdischarge follow-up, a health system quality indicator, corresponded with improved longer-term posthospital care for depression. METHODS: The authors assessed outpatient mental health encounters, including telephone contact, within seven days of discharge among 56,785 Veterans Health Administration patients with an inpatient stay for major depression between 2005 and 2010. They also assessed readmission rates, antidepressant medication coverage, and psychotherapy visits for 90 days following discharge. RESULTS: The percentage of patients who received outpatient follow-up within seven days of discharge increased from 39% to 75%. After adjustment for patient characteristics, patients were more likely to receive adequate psychotherapy in 2010 than in 2005 (odds ratio=1.29, 95% confidence interval=1.19-1.40). There were no significant changes in readmission or antidepressant treatment. CONCLUSIONS: Timely outpatient follow-up after hospitalization may not reduce readmission or substantially improve longer-term depression treatment, suggesting a need for additional or more effective care processes.