Reducing Hospital Readmission Among Medical Patients With Depressive Symptoms
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Depression
- Sponsor
- Boston Medical Center
- Enrollment
- 709
- Locations
- 1
- Primary Endpoint
- All-cause readmission rates
- Status
- Completed
- Last Updated
- 8 years ago
Overview
Brief Summary
Project Re-Engineered Discharge (Project RED) has previously demonstrated that patients who received the RED were 30% less likely than patients receiving usual care to access inpatient or emergency services within 30 days of discharge. In this project, the investigators add a new dimension to RED by integrating screening, referral and treatment for depression into the original RED intervention and determining if this enhanced intervention increases the effectiveness of RED in preventing readmissions and controlling costs in the 180 days after discharge for patients with signs of depression.
Investigators
Brian Jack
Professor and Chair
Boston Medical Center
Eligibility Criteria
Inclusion Criteria
- •Over 18 years of age
- •Admitted to any Boston Medical Center inpatient service or for observation
- •Screen positive for depressive symptoms (Patient Health Questionnaire - 2 \>/= 3)
- •Speaks English with health care providers
- •Has access to a telephone
- •Live in the Boston area and don't plan on leaving the Boston area for more than 2 weeks in the next 6 months
- •Screen positive for depressive symptoms (PHQ -9 \>/= 10)
Exclusion Criteria
- •Has plans for inpatient rehabilitation, nursing home, or other institutional settings after discharge.
- •Suicidal precautions
- •Sickle Cell Crisis (SCC)
- •Alcohol and/or drug dependence
- •Diagnosis of Bipolar Disorder, Schizophrenia or other Psychotic Disorder
- •In police custody
Outcomes
Primary Outcomes
All-cause readmission rates
Time Frame: 30 days and 90 days post-discharge from hospital at index admission
The primary hypothesis is to test whether the RED intervention plus the collaborative-care approach for depression (RED-D) will reduce the all-cause 30 and 90 day hospital readmission rates for patients who screen positive for depressive symptoms
All-cause reutilization rates
Time Frame: 30 & 90 days post discharge from index hospitalization
The primary hypothesis is to test whether the RED intervention plus the collaborative-care approach for depression (RED-D) will reduce the all-cause 30 and 90 day hospital utilization rates for patients who screen positive for depressive symptoms
Secondary Outcomes
- cost-saving(90 & 180 after discharge from index hospitalization)
- Mental Health Related Quality of Life(30 days and 90 days after discharge from index admission)