Practices Preventing Rehospitalization of Individuals With Schizophrenia

Abstract

While psychosocial care approaches such as assertive community treatment or partial hospitalization can help prevent psychiatric inpatient stay, the ability of specific services to prevent admission is less clear (e.g., recognizing signs of impending relapse, promoting daily structure). Therefore, within 3 months of psychiatric hospital discharge, this study examined the extent to which inpatient readmission among 264 persons with schizophrenia was averted by interventions addressing medication education, symptom education, service continuity, social skills, daily living, daily structure, and family issues. After accounting for demographic characteristics in logistic regression equations, findings suggested that interventions addressing symptom education, service continuity, and daily structure were most effective in preventing inpatient stay among individuals with four or more prior hospitalizations. However, these services became statistically insignificant in preventing readmission among counterparts with fewer previous inpatient stays. While protective effects may differ among persons with varying hospitalization histories, results indicate that resource-poor outpatient centers could focus on these three interventions when care must be limited to rehospitalization prevention.

Revisiting the Psychiatric Day Hospital Experience 6 Months After Discharge: How Was the Transition and What Have Clients Retained?

“…It requires a careful assessment and planning that could be improved from what was done at the time of the study. Delayed or absent outpatient follow-up psychiatric treatment has been shown to contribute to poor outcomes [33], including relapse and rehospitalizations [34], reduced quality of life [35] and suicide [36]. From a social support perspective, ensuring that the clients are well surrounded is an important aspect that promotes health and well-being [37].…”

Revisiter l’expérience en hôpital de jour six mois après le congé : parcours et perceptions des personnes utilisatrices

“…Ceci s'explique peutêtre par le fait que lorsque l'on examine les services utilisés au cours des six mois suivant le congé, tous ont obtenu un suivi médical mais seulement deux participants ont eu des rencontres avec d'autres professionnels de la santé (travailleur social en première ligne) ou dans des organismes communautaires pour répondre à leurs besoins exprimés en HDJ, de poursuivre la thérapie. Des études ont démontré qu'une absence ou un délai dans l'amorce d'un suivi en externe après une hospitalisation contribue à des rechutes et à des ré-hospitalisations (Prince, 2006), à une réduction de la qualité de vie (Boyer et al, 2000) et au suicide (Goldacre et al, 1993). Par ailleurs, Boyer et al (2000) et Olfson et al (1998) ont trouvé que la prise de contact avec la nouvelle équipe avant le congé, facilitait la transition selon certains participants.…”

Effect of Introducing a Care Pathway to Standardize Treatment and Nursing of Schizophrenia

“…To be included in the sample the patients should have been admitted at least once in hospital before the study for a severe psychotic episode with or without aggressive behavior. The authors hypothezised that the new care pathway would result in improved better care as measured using the hospital readmission rates as primary outcome and therefore was calculated the sample size needed to detect a statistical difference in the rates of hospital admissions 3 months after discharge (Prince 2006). Since also nondrug/organizational interventions showed their effectiveness in reducing re-admissions rates for schizophrenia from 64% (patients not assisted) to 24% (patients who received the interventions), it was expected that the care pathway succeeded to control readmissions to 20% to be clinically relevant (Prince 2006).…”