Disharmony of Inpatient and Outpatient Services Hampers Treatment of Schizophrenics

Study of New York's services system for mentally ill Medicaid patients

From 1991 to 1998, researchers from the Institute for Health, Health Care Policy, and Aging Research at Rutgers, The State University of New Jersey, studied the care of schizophrenia patients who are covered by Medicaid in New York State.

Focusing on how variations in care received by these patients affected the treatment outcomes, the research team surveyed all 107 general hospitals in New York with adult inpatient psychiatric units and made 52 site visits. They also interviewed patients during and after their hospitalizations.

Key Findings

  • Care for patients with schizophrenia is frequently episodic and crisis-oriented rather than continuous or rehabilitative in nature.

  • Linkages between inpatient and outpatient care are often inadequate, with one third of patients reporting that no outpatient visit had been scheduled for them at the time of discharge.

  • Patients who had contact with their outpatient therapist prior to discharge reported fewer symptoms and had less difficulty controlling them three months after discharge, compared with patients who had no such contact.