Colocated general medical care and preventable hospital admissions for veterans with serious mental illness

Objective: This study examined whether veterans with serious mental illness in mental health settings with colocated general medical care had fewer hospitalizations for ambulatory care-sensitive conditions than veterans in other settings. Methods: Using 2007 data, the study examined hospitalizations for ambulatory care-sensitive conditions with zero-inflated negative binomial regression controlling for demographic, clinical, and facility characteristics. Results: Of 92,268 veterans with serious mental illness, 9,662 (10.5%) received care at ten sites with colocated care and 82,604 (89.5%) at 98 sites without it. At sites without colocation, 5.1% had a hospitalization for an ambulatory care-sensitive condition, compared with 4.3% at sites with colocation. Attendance at sites with colocated care was associated with an adjusted count of hospitalizations of .76 compared with attendance at sites with no colocation (β=-.28, 95% confidence interval=.47 to -.09, p=.004). Conclusions: Colocation of general medical services in the mental health setting was associated with significantly fewer preventable hospitalizations.