Follow-Up After Hospitalisation for Mental Illness - 7 Days and 30 Days

Identifying Attributes

Care Settings
Care Transitions
Country
United States of America
Publishing Organisation
Centers for Medicare & Medicaid Services (CMS): Inpatient Psychiatric Facility Quality Reporting Program
Type of Quality Indicator
Process
IOM Quality Dimension
Timeliness
Domain
Follow-Up

Defining Attributes

Definition

Percentage inpatient psychiatric facility hospitalisations for treatment of select mental health disorders that were followed by an outpatient mental health care encounter within 7 days and 30 days of discharge.

Numerator

Discharges from a psychiatric facility that are followed by an outpatient mental health encounter within 7 days and 30 days.

Denominator

Number of discharges paid under the inpatient psychiatric facility prospective payment system during the measurement period for Medicare fee-for-service patients with a principal diagnosis of mental illness. Specifically: Discharged with a principal diagnosis of mental illness that would necessitate follow-up care with a mental health professional; Discharged alive to ensure they are eligible for follow-up care; Enrolled in Medicare Parts A and B during the month of the discharge date and at least one month after the discharge date to ensure data are available to capture the index admission and follow-up visits.; Six years of age or older on the date of discharge because follow-up with a mental health professional may not always be recommended for younger children.

Exclusions

Inpatient Psychiatric Facility discharges for patients: Admitted or transferred to acute and non-acute inpatient facilities within the 7-day/30 day follow-up period because admission or transfer to other institutions may prevent an outpatient follow-up visit from taking place; Discharged or transferred to other institutions, including direct transfer to a prison, within the 7-day/30 day follow-up period because those patients may not have the opportunity for an outpatient follow-up visit; Who died during the 7-day/30 day follow-up period because patients who expire may not have the opportunity for an outpatient follow-up visit; Who use hospice services or elect to use a hospice benefit any time during the measurement year, regardless of when the services began because patients in hospice may require different follow-up services.

Use of Risk Adjustment
No
Risk Adjustments

None

Stratifications

7 days and 30 days of follow-up.

Data Attributes

Type of Data Collection
Administrative data
Data Collection Methods

Medicare fee-for-service (FFS) claims data.

Frequency of Data Collection
Annually
Frequency of Data Collection in Days
365
Reporting Methods

Inpatient Psychiatric Facility Quality Reporting Program (CMS and Providers) CMS Care Compare - Hospitals and Provider Compare (Publicly reported).

Reporting Frequency
Annually
Reporting Frequency in Days
365
Indicator Has Recommended Targets
No

Source and Reference Attributes

Evidence Source

Benjenk I, Shields M, Chen J. Measures of Care Coordination at Inpatient Psychiatric Facilities and the Medicare 30-Day All-Cause Readmission Rate. Psychiatr Serv. 2020 Oct 1;71(10):1031-1038. doi: 10.1176/appi.ps.201900360. Epub 2020 Aug 25. PMID: 32838680; PMCID: PMC7837251. data.cms.gov/provider-data/topics/hospitals/psychiatric-unit-services#follow-up-care data.cms.gov/provider-data/topics/hospitals/measures-and-current-data-collection-periods Reported on data.cms.gov/provider-data/dataset/dc76-gh7x

Link to Measurement Tools
Quality Indicator Confirmed to be Part of a Program Used to Monitor Quality and Safety of Care Among Older People at a Population-Level between 2012-2022
Yes
Assessed by the Australian Consortium for Aged Care Collaborators as Generally Containing Good Properties (Importance and Scientific Acceptability)
Yes
Australian Consortium for Aged Care Endorsed
No
Identified by PHARMA-Care Project
No
Upload Date
12 March 2025