Correlates of emergency department use by individuals with bipolar disorder enrolled in a collaborative care implementation study

Abstract

Objective: The study assessed correlates of emergency department use among participants in a collaborative care program for bipolar disorder. Methods: Community-based clinics from two states implemented Life Goals-Collaborative Care (LG-CC), an evidencebased model that includes self-management sessions and care management contacts. Logistic regression determined participant factors associated with emergency department use between six and 12months after LG-CC implementation. Results: Of 219 participants with baseline and 12-month data, 24% reported at least one emergency department visit. Participants with a recent homelessness history (odds ratio [OR]=3.76, p=.01) or five or more care management contacts (OR=2.62, p=.05) had a higher probability of visiting an emergency department, after the analyses were adjusted for demographic and clinical factors, including physical health score and hospitalization history. Conclusions: Participants in a collaborative care program who had a history of homelessness were more likely to use the emergency department, suggesting a greater need for more intensive care coordination.