While bed occupancy for both general mental health and substance has gone down, outpatient services and total number of veterans treated have increased. The total number of persons who received any mental health care increased in FY 98 to 649,814 up from 609,523 in FY 1997. Overall mental health program costs have decreased and cost per patient have gone down as well. Readmission days for patients discharged from inpatient care have decreased while number of outpatient visits in 30 days and 6 months have increased. Continuity of care, as measured by the number of two-month periods in the first 6 months after discharge in which a patient had two or more outpatient visits has also increased.
Continuity of care is essential for maintaining high quality of care.
It remains important, however, to monitor local variations in service delivery to insure that the same high quality of care be maintained across all facilities and all VISNs. The current thrust in substance abuse programming in many VA medical facilities has been in the direction of eliminating inpatient substance abuse treatment. Part of this program restructuring has been well thought out with the development of alternative residential resources, expanded ambulatory care, and the provision of acute inpatient care when necessary. However, in FY 1996, there was a decrease in both inpatient and outpatient workloads and VA treated fewer veterans for substance abuse than in FY 1995. This was the first time that such a decrease has occurred since the initiation of VA's expansion of its substance abuse treatment capability in 1990.