La EM, Morrissey JP, Hassmiller Lich K, Domino ME, Seibert J, Waller A. Impact of state psychiatric hospital waitlists on monthly admissions. Psychiatr Serv. 2017 Aug 15. doi: 10.1176/

OBJECTIVE: This study estimated the effects of a waitlist policy on the monthly number and case mix of admissions to state psychiatric hospitals (SPHs) in North Carolina (NC).

METHODS: Descriptive analyses compared pre/postwaitlist differences in the monthly number and case mix of nonforensic adult admissions (N=72,035) to NC’s four SPHs by using data from the three years before and the three years after the waitlist announcement. Hospital-level fixed-effects regression models further evaluated the waitlist policy’s impact on the number and case mix of admissions.

RESULTS: Regression results confirmed that the waitlist policy was associated with both fewer admissions and changes to the case mix of admissions, including a 4.2% decrease in the percentage of monthly admissions by patients with diagnoses of substance abuse disorders (p=.002) across all months postwaitlist (partially offset by an increase of patients with diagnoses of severe mental illness alone).

CONCLUSIONS: Waitlists led to reduced monthly admissions and altered case mix following implementation at NC SPHs.

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