A Successful Walk-In Psychiatric Model for Integrated Care

David S. Kroll; Carol Latham; Janice Mahal; Meagan Siciliano; Laura S. Shea; Lisa Irwin; Bonnie Southworth; David F. Gitlin

doi:10.3122/jabfm.2019.04.180357

Article Figures & Data

Figures

Tables

Download figure
Open in new tab
Figure 1.
Initial psychiatry evaluations per month (XbarS Chart).
Download figure
Open in new tab
Figure 2.
Return psychiatry encounters per month (XbarS Chart).

Tables

Figures

View popup

Table 1.

Characteristics of Patients Who Accessed Psychiatry for the First Time at Scheduled and Walk-In Integrated Care Encounters between October 2015 and September 2017

	No. (%) Scheduled	Walk-in	P-Value
N	268	222
Age, mean (standard deviation)	48 (16)	47 (15)	.758
Female	187 (70)	169 (76)	.116
Insurance status			<.0001
Private	115 (43)	51 (23)
Medicare	56 (21)	53 (24)
Medicaid	43 (16)	60 (27)
NHP	53 (20)	54 (24)
None	1 (0)	4 (2)
Marital Status			.030
Single	143 (54)	133 (60)
Divorced or separated	28 (10)	33 (15)
Widowed	8 (3)	8 (4)
Married or partnered	88 (33)	47 (21)
Language			.121
English	241 (91)	190 (86)
Spanish	19 (7)	28 (13)
Other	6 (2)	4 (2)
Education			.037
Less than high school	28 (13)	32 (17)
High school or GED	99 (44)	98 (52)
College or higher	97 (43)	59 (31)
Race			<.0001
White	127 (48)	62 (28)
Black	69 (26)	87 (40)
Hispanic	32 (12)	46 (21)
Asian	6 (2)	4 (2)
Native	0 (0)	1 (0)
Other	28 (11)	18 (8)
Diagnosis			.034
Mood disorder	144 (54)	115 (52)
Anxiety disorder	51 (19)	32 (14)
Trauma-related disorder	16 (6)	24 (11)
Adjustment disorder	23 (9)	15 (7)
Attention deficit disorder	9 (3)	5 (2)
Psychotic disorder	4 (1)	9 (4)
Substance use disorder	5 (2)	6 (3)
Neurological or developmental disorder	2 (1)	6 (3)
Somatoform disorder	2 (1)	2 (1)
Personality disorder	0 (0)	1 (0)
Eating disorder	0 (0)	1 (0)
Other	12 (4)	6 (3)
Prescribed medication	187 (70)	167 (75)	.180
Transferred to the ED	1 (0)	2 (1)	.456

ED, emergency department; GED, graduate equivalency degree; NHP, Neighborhood Health Plan.
Some demographic variables were listed as “unavailable” or “declined” in some patient records, and these were omitted from the percentage calculations and χ² tests.
Of a total of 490 patient records (268 scheduled, 222 walk-in), 490 included gender, 490 included insurance status, 488 (267 scheduled, 221 walk-in) included marital status, 488 (266 scheduled, 222 walk-in) included language, 413 (224 scheduled, 189 walk-in) included educational level, 480 (262 scheduled, 218 walk-in) included race, and 490 (268 scheduled, 222 walk-in) included a billing diagnosis.
“Other” billing diagnoses include sleep disorders, sexual disorders, learning disorders, medical diagnoses, and unspecified mental conditions. “Prescribed medication” and “Transferred to the ED” descriptors apply to the initial visit only.
Statistical significance determined by P < .05.