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Published Online: 6 October 2020

The Impact of the North Carolina Statewide Telepsychiatry Program (NC-STeP) on Patients’ Dispositions From Emergency Departments

Abstract

Objective:

The number of patients seeking treatment in emergency departments (EDs) for mental health reasons is rising, and these patients are often kept in the ED until they can be treated or discharged, leading to overcrowding. Telepsychiatry may alleviate overcrowding by increasing the rate of discharges home.

Methods:

ED discharge records for 86,931 patients with psychiatric symptoms were examined to compare patient disposition and length of stay (LOS) between times when the North Carolina Statewide Telepsychiatry Program (NC-STeP) program was available or unavailable.

Results:

For patients with a LOS of >2 days (N=3,144) and when NC-STeP was available, 62% (N=1,941) were discharged home, and 29% (N=922) were transferred to a psychiatric facility. When NC-STeP was unavailable (N=2,662), 43% (N=1,139) of these patients were discharged home, and 46% (N=1,230) were transferred to a psychiatric facility. For patients with a LOS of 1–2 days and when NC-STeP was available (N=41,713), 77.0% (N=32,131) were discharged home, and 15.4% (N=6,441) were transferred to a psychiatric facility, compared with 74.2% (N=29,237) discharged home and 13.9% (N=5,495) transferred to a psychiatric facility when NC-STeP was unavailable (N=39,412). The increases in discharges home and decreases in referrals to psychiatric facilities when NC-STeP was available were statistically significant for patients in both groups (p<0.001).

Conclusions:

Results suggest that telepsychiatry programs such as NC-STeP increase the number of discharges home and decrease transfers to psychiatric facilities, likely promoting patient satisfaction and improving ED efficiency.

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Information & Authors

Information

Published In

Go to Psychiatric Services
Go to Psychiatric Services
Psychiatric Services
Pages: 1239 - 1244
PubMed: 33019858

History

Received: 27 August 2019
Revision received: 27 April 2020
Accepted: 21 May 2020
Published online: 6 October 2020
Published in print: December 01, 2020

Keywords

  1. Emergency psychiatry
  2. Telemedicine
  3. Telepsychiatry NC-STeP
  4. Boarding

Authors

Details

Radhika Jamanadas Kothadia, M.D. [email protected]
Department of Psychiatry and Behavioral Medicine, Brody School of Medicine, Greenville, North Carolina (Kothadia, Saeed, Torres); Department of Public Health, East Carolina University, Greenville, North Carolina (Jones).
Katherine Jones, Ph.D.
Department of Psychiatry and Behavioral Medicine, Brody School of Medicine, Greenville, North Carolina (Kothadia, Saeed, Torres); Department of Public Health, East Carolina University, Greenville, North Carolina (Jones).
Sy Atezaz Saeed, M.D., M.S.
Department of Psychiatry and Behavioral Medicine, Brody School of Medicine, Greenville, North Carolina (Kothadia, Saeed, Torres); Department of Public Health, East Carolina University, Greenville, North Carolina (Jones).
Matthew J. Torres, B.S.
Department of Psychiatry and Behavioral Medicine, Brody School of Medicine, Greenville, North Carolina (Kothadia, Saeed, Torres); Department of Public Health, East Carolina University, Greenville, North Carolina (Jones).

Notes

Send correspondence to Dr. Kothadia ([email protected]).

Funding Information

Dr. Saeed is the executive director of the North Carolina Statewide Telepsychiatry Program, funded by the North Carolina General Assembly, the Duke Endowment, and the North Carolina Office of Rural Health. The North Carolina Department of Health and Human Services provides administrative oversight of the funding. The other authors report no financial relationships with commercial interests.

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