INFLUENCES ON FIT BETWEEN PSYCHIATRIC-PATIENTS PSYCHOSOCIAL NEEDS ANDTHEIR HOSPITAL DISCHARGE PLAN

Objective: The study examined factors that help determine a good or po or fit between the psychosocial support needs of hospitalized patients and the hospital's discharge plan. Methods: The Mount Sinai Discharge Planning Inventory was completed weekly for 494 consecutive admission s to the hospital's adult inpatient psychiatric units. The resources t hat patients brought with them into the hospitalization in the areas o f housing, entitlements, daily activities, and psychiatric treatment w ere recorded as well as the resources that would constitute an optimal discharge plan. Good or poor fit was operationally defined by the mat ch between the optimal, first-choice plan and the implemented discharg e plan. Results: One-third of admissions were found to have an optimal fit on admission in all resource categories studied. For patients who entered the hospital with suboptimal resources, discharge planning wa s significantly more likely to establish clinically relevant psychiatr ic treatment options and to strengthen daily living activities than to change housing resources. Certain diagnoses and a history of drug abu se, criminality, violence, and treatment noncompliance were associated with poorer fits with first-choice disposition options. Conclusions: The Mount Sinai Discharge Planning Inventory provides a method to syst ematically evaluate discharge planning by tracking progress toward sec uring relevant posthospital care and support.