Comparison of Self-report and Clinician-rated Measures of Psychiatric Symptoms and Functioning in Predicting 1-year Hospital Readmission

Clements, Karen M.; Murphy, Jane M.; Eisen, Susan V.; Normand, Sharon‐Lise T.

doi:10.1007/s10488-006-0066-y

Cited by 30 publications

(23 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…We recognize that the diagnostic and residential categories used in this study may not accurately reflect the heterogeneity of functioning and illness severity within each group and that GAF scores are a limited measure of overall functioning (Clements et al, 2006). Given that our sample was relatively small and limited to inpatients at one psychiatric facility, results may not reflect a complete incidence of readmission.…”

Section: Discussionmentioning

confidence: 95%

Predicting Time to Readmission in Patients With Recent Histories of Recurrent Psychiatric Hospitalization

Schmutte¹,

Dunn²,

Sledge³

2010

Journal of Nervous &Amp; Mental Disease

View full text Add to dashboard Cite

The most robust predictor of future psychiatric hospitalization is the number of previous admissions. About half of psychiatric inpatients with histories of repeated hospitalizations are readmitted within 12 months. This study sought to determine which patient characteristics predicted time-to-readmission within 12 months after controlling for the number of previous hospitalizations in 75 adults with recent histories of recurrent admissions and 75 matched controls. Results revealed multiple clinical and demographic between-group differences at index hospitalization. However, the only predictors of shorter time-to-readmission in multivariate Cox proportional hazards were unemployment (hazards ratio = 9.26) and residential living status (hazards ratio = 2.05) after controlling for prior hospitalizations (hazard ratio = 1.24). Unemployment and residential living status were not proxies of psychosis or moderated by illness severity or comorbid substance use. Results suggest that early psychiatric readmission may be more influenced by residential and employment status than by severe mental illness.

show abstract

Section: Discussionmentioning

confidence: 95%

Predicting Time to Readmission in Patients With Recent Histories of Recurrent Psychiatric Hospitalization

Schmutte¹,

Dunn²,

Sledge³

2010

Journal of Nervous &Amp; Mental Disease

View full text Add to dashboard Cite

show abstract

“…Being a skilled worker turned out to be a protective factor while being unemployed a risk factor [57]; full-time employment turned out as protective as well vs part-time employment, receiving social assistance or being unemployed [58]. Patients who were either employed or students showed a lower readmission risk [46]; also an increased risk was found for patients not in employment vs those who were employed (including subsistence and in the Army forces) [60] and unemployment was found as a risk factor for early readmission [29]. …”

Section: Categories Of Pre-discharge Variables Analysedmentioning

confidence: 99%

Pre-discharge factors predicting readmissions of psychiatric patients: a systematic review of the literature

et al. 2016

View full text Add to dashboard Cite

BackgroundReadmission rate is considered an indicator of the mental health care quality. Previous studies have examined a number of factors that are likely to influence readmission. The main objective of this systematic review is to identify the studied pre-discharge variables and describe their relevance to readmission among psychiatric patients.MethodsStudies on the association between pre-discharge variables and readmission after discharge with a main psychiatric diagnosis were searched in the bibliographic databases Ovid Medline, PsycINFO, ProQuest Health Management and OpenGrey. Relevant publications published between January 1990 and June 2014 were included. For each variable, the number of papers that considered it as a predictor of readmission and that found a significant association was recorded, together with the association direction and whether it was found respectively in bivariate and in multivariate analyses.ResultsOf the 734 articles identified in the search, 58 papers were included in this review, mainly from the USA and concerning patients with severe mental disorders. Analysed variables were classified according to the following categories: patients’ demographic, social and economic characteristics; patients’ clinical characteristics; patients’ clinical history; patients’ attitude and perception; environmental, social and hospital characteristics; and admission and discharge characteristics. The most consistently significant predictor of readmission was previous hospitalisations. Many socio-demographic variables resulted as influencing readmission, but the results were not always homogeneous. Among other patients’ clinical characteristics, diagnosis and measures of functional status were the most often used variables. Among admission characteristics, length of stay was the main factor studied; however, the results were not very consistent. Other relevant aspects resulted associated with readmission, including the presence of social support, but they have been considered only in few papers. Results of quality assessment are also reported in the review. The majority of papers were not representative of the general psychiatric population discharged from an inpatient service. Almost all studies used multivariate analytical methods, i.e., confounders were controlled for, but only around 60% adjusted for previous hospitalisation, the variable most consistently considered associated to readmission in the literature.ConclusionsThe results contribute to increase knowledge on pre-discharge factors that could be considered by researchers as well as by clinicians to predict and prevent readmissions of psychiatric patients. Associations are not always straightforward and interactions between factors have to be considered.Electronic supplementary materialThe online version of this article (doi:10.1186/s12888-016-1114-0) contains supplementary material, which is available to authorized users.

show abstract

“…Results have varied somewhat in terms of the incremental validity of self-report measures in predicting important clinical outcomes beyond that predicted by demographic information and clinician assessments (Clements, Murphy, Eisen, & Normand, 2006). In part, this refiects the narrow scope of measures used to assess psychological functioning, and the fact that important clinical/cognitive domains (e.g., impulsivity, confusion) are not always adequately represented.…”

mentioning

confidence: 99%

Development and preliminary validation of the Level of Care Index (LOCI) from the Personality Assessment Inventory (PAI) in a psychiatric sample.

Sinclair¹,

Slavin-Mulford²,

Antonius³

et al. 2013

Psychological Assessment

View full text Add to dashboard Cite

Research over the last decade has been promising in terms of the incremental utility of psychometric tools in predicting important clinical outcomes, such as mental health service utilization and inpatient psychiatric hospitalization. The purpose of this study was to develop and validate a new Level of Care Index (LOCI) from the Personality Assessment Inventory (PAI). Logistic regression was initially used in a development sample (n = 253) of psychiatric patients to identify unique PAI indicators associated with inpatient (n = 75) as opposed to outpatient (n = 178) status. Five PAI variables were ultimately retained (Suicidal Ideation, Antisocial Personality-Stimulus Seeking, Paranoia-Persecution, Negative Impression Management, and Depression-Affective) and were then aggregated into a single LOCI and independently evaluated in a second validation sample (n = 252). Results indicated the LOCI effectively differentiated inpatients from outpatients after controlling for demographic variables and was significantly associated with both internalizing and externalizing risk factors for psychiatric admission (range of ds = 0.46 for history of arrests to 0.88 for history of suicidal ideation). The LOCI was additionally found to be meaningfully associated with measures of normal personality, performance-based tests of psychological functioning, and measures of neurocognitive (executive) functioning. The clinical implications of these findings and potential utility of the LOCI are discussed.

show abstract

Comparison of Self-report and Clinician-rated Measures of Psychiatric Symptoms and Functioning in Predicting 1-year Hospital Readmission

Cited by 30 publications

References 34 publications

Predicting Time to Readmission in Patients With Recent Histories of Recurrent Psychiatric Hospitalization

Predicting Time to Readmission in Patients With Recent Histories of Recurrent Psychiatric Hospitalization

Pre-discharge factors predicting readmissions of psychiatric patients: a systematic review of the literature

Development and preliminary validation of the Level of Care Index (LOCI) from the Personality Assessment Inventory (PAI) in a psychiatric sample.

Contact Info

Product

Resources

About