Reducing Hospital Readmissions in Patients With Depressive Symptoms

Reducing Hospital Readmission Among Medical Patients With Depressive Symptoms

Project Re-Engineered Discharge (Project RED) has previously demonstrated that patients who received the RED were 30% less likely than patients receiving usual care to access inpatient or emergency services within 30 days of discharge. In this project, the investigators add a new dimension to RED by integrating screening, referral and treatment for depression into the original RED intervention and determining if this enhanced intervention increases the effectiveness of RED in preventing readmissions and controlling costs in the 180 days after discharge for patients with signs of depression.

Inclusion Criteria:

• Over 18 years of age
• Admitted to any Boston Medical Center inpatient service or for observation
• Screen positive for depressive symptoms (Patient Health Questionnaire - 2 >/= 3)
• Speaks English with health care providers
• Has access to a telephone
• Live in the Boston area and don't plan on leaving the Boston area for more than 2 weeks in the next 6 months
• Screen positive for depressive symptoms (PHQ -9 >/= 10)

Exclusion Criteria:

• Has plans for inpatient rehabilitation, nursing home, or other institutional settings after discharge.
• Suicidal precautions
• Sickle Cell Crisis (SCC)
• Alcohol and/or drug dependence
• Diagnosis of Bipolar Disorder, Schizophrenia or other Psychotic Disorder
• In police custody