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Published Online: 27 October 2014

The Return on Investment of Postdischarge Follow-Up Calls for Suicidal Ideation or Deliberate Self-Harm

Abstract

Providing follow-up calls to patients after they leave the hospital is not only good clinical practice, but it can help with the bottom line. In this study, the authors estimated the return on investment (ROI) for every $1 spent calling patients with suicidal ideation or deliberate self-harm who had been discharged from a hospital or emergency department. The ROI for the calls ranged from $1.76 to $2.43—a significant return that “supports the business case for payers, particularly Medicaid, to invest in postdischarge follow-up calls,” the authors concluded.

Abstract

Objective

Transitions of care are critical for individuals at risk of suicide. This study determined the return on investment (ROI) for providing postdischarge follow-up calls to patients at risk of suicide who are discharged from a hospital or an emergency department.

Methods

Claims data were from the 2006–2011 Truven Health MarketScan Commercial Claims and Encounters Database and Multi-State Medicaid Database. Cost estimates were from eight call centers that provide postdischarge follow-up calls. The ROI was estimated for the 30 days after discharge and was calculated from a payer’s perspective (return gained for every $1 invested). One-way and probabilistic sensitivity analyses were used to examine the influence of variations of ROI model inputs.

Results

Under base case assumptions, the estimated ROI was $1.76 for commercial insurance and $2.43 for Medicaid for patients discharged from a hospital and $1.70 for commercial insurance and $2.05 for Medicaid for those discharged from an emergency department. Variation in the effect size of postdischarge contacts on reducing readmission had the largest effect on the ROI, producing a range from $0 to $4.11. The ROI would be greater than $1 for both payers and across both discharge settings as long as postdischarge contact could reduce readmission by at least 13.3%. Sensitivity analyses indicated a 77% probability (commercial) and an 88% probability (Medicaid) that the ROI would be greater than $1 among hospital discharges; the probabilities among emergency department discharges were 74% (commercial) and 82% (Medicaid).

Conclusions

The study supports the business case for payers, particularly Medicaid, to invest in postdischarge follow-up calls.

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Information & Authors

Information

Published In

Go to Psychiatric Services
Go to Psychiatric Services

Cover: Deep Cove Lobster Man, by N. C. Wyeth, ca. 1938. Oil on gessoed board (renaissance panel). Accession number 1939.16. Courtesy of the Pennsylvania Academy of Fine Arts, Philadelphia, Joseph E. Temple Fund.

Psychiatric Services
Pages: 1012 - 1019
PubMed: 24788454

History

Published in print: August 2014
Published online: 27 October 2014

Authors

Details

John S. Richardson, M.P.H.
Mr. Richardson and Dr. Mark are with the Division of Behavioral Health and Quality Research, Truven Health Analytics, Bethesda, Maryland. Mr. Richardson is also currently a student with the Department of Health Management and Policy, University of Michigan, Ann Arbor. Dr. McKeon is with the Division of Suicide Prevention, Substance Abuse and Mental Health Services Administration, Rockville, Maryland. Send correspondence to Dr. Mark (e-mail: [email protected]).
Tami L. Mark, Ph.D., M.B.A.
Mr. Richardson and Dr. Mark are with the Division of Behavioral Health and Quality Research, Truven Health Analytics, Bethesda, Maryland. Mr. Richardson is also currently a student with the Department of Health Management and Policy, University of Michigan, Ann Arbor. Dr. McKeon is with the Division of Suicide Prevention, Substance Abuse and Mental Health Services Administration, Rockville, Maryland. Send correspondence to Dr. Mark (e-mail: [email protected]).
Richard McKeon, Ph.D., M.P.H.
Mr. Richardson and Dr. Mark are with the Division of Behavioral Health and Quality Research, Truven Health Analytics, Bethesda, Maryland. Mr. Richardson is also currently a student with the Department of Health Management and Policy, University of Michigan, Ann Arbor. Dr. McKeon is with the Division of Suicide Prevention, Substance Abuse and Mental Health Services Administration, Rockville, Maryland. Send correspondence to Dr. Mark (e-mail: [email protected]).

Funding Information

Substance Abuse and Mental Health Services Administration10.13039/100000058: HHSS283200700029I/HHSS28342002T

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