A continuum of care from hospital to community

This study evaluates the impact of deinstitutionalization on a multiorganizational inpatient and outpatient treatment system. Data are presented on the system's use by 613 patients over an 8 1/2 year period. Goals of a deinstitutionalization program, increasing outpatient service utilization and decreasing rehospitalization, were not clearly achieved. The needs of an inpatient and outpatient care system include effective communication between systems of care, provisions for patient drift from one community to another, and outpatient services of sufficient breadth and quantity to meet the needs of various service users, particularly the severely disabled.This research was partially supported by a NRSA training grant, No. 2 T32 MH17053-06.