COLUMBUS, Ohio – Hospital readmission rates for trauma patients can be cut significantly with more extensive mental healthcare after discharge, a new study indicates.
Readmission rates are a common hospital performance metric. They serve as an indicator that patient needs are being met, and reducing readmission rates tends to lower health care costs.
However, victims of trauma — things like motor vehicle crashes, firearm injuries and domestic violence —often need more than treatment of their physical injuries. The new research shows that long-term mental health care is an important part of a complete recovery for these patients and offers a large improvement over the current standard of care.
The five-year study, led by an Ohio State researcher, followed 171 patients seen at a University of Washington trauma center who were randomized to receive either standard care or a comprehensive intervention designed to address their mental health.
The study found that if hospitals consistently and comprehensively supported trauma survivors with mental health needs, including after they’re discharged, the survivors were less likely to find themselves back in the hospital in crisis.
“Being able to manage PTSD and other mental health concerns early on and receive regular follow-up support can prevent adverse long-term health problems and increase a survivor’s ability to live a productive, meaningful life,” said Laura Prater, the study’s lead author and an assistant professor at the Ohio State University College of Public Health.
The American College of Surgeons Committee on Trauma requires that trauma centers — hospitals that treat patients with serious, life-threatening injuries — acknowledge mental health and make referrals for patients experiencing psychological distress. But there’s no uniform protocol for how that should be done, Prater said.
The intervention study did three things; asked trauma survivors to describe their personal post-traumatic concerns, coordinated mental health care during hospitalization, and offered patients ongoing 24/7 support after leaving the hospital.
Researchers found significant reductions in emergency department and inpatient hospital use among those who experienced the intervention.
Three to six months after the initial trauma, almost twice as many standard care patients found themselves back in the hospital – 27% of the time, compared to 16% of intervention patients.
At 12 to 15 months, 31% of those in the standard care group had made a return visit to the hospital, versus 17% of those in the intervention group.
About 30 million Americans experience traumatic injuries each year, and 1.5 to 2.5 million of them require hospitalization, previous research has shown. And as many as 4 out of 10 people hospitalized for trauma experience post-traumatic stress disorder, or PTSD, and other psychological challenges.
Prater said it’s likely that the 24/7 access to support through text messaging or phone calls was particularly helpful in reducing hospital readmissions.
“The immediate text message or phone call response to questions and concerns is potentially the most meaningful element of the intervention, from the perspective of the survivors. A lot of places use MyChart or another form of messaging, but responses can be delayed and that is problematic if someone is feeling overwhelmed,” she said.
“Having an immediate connection helped patients and their families to feel like they weren’t in it alone.”
