Rapid and frequent psychiatric readmissions: associated factors

Abstract

Identifying factors that are associated with rehospitalisation and understanding their importance is necessary to reduce the risk of readmission. This study suggests that particular demographic, clinical and treatment factors require consideration to tackle the seemingly wide range of factors that could be affecting readmission to inpatient services.

Factors associated with 30-day and 1-year readmission among psychiatric inpatients in Beijing China: a retrospective, medical record-based analysis

“…The 30-day readmission rate (16.69%) in this study was consistent with some studies conducted in other countries and settings [7,9]; nevertheless, the 30-day readmission rate had large variations from previous reports. A report published by the Organization for Economic Cooperation and Development suggested that the 30-day readmission rate for schizophrenia varied from 5 to 20% among 20 countries [39] and the 30-day readmission rate was 4.5% (1598/37,796) in a Korean sample [8].…”

“…Readmissions may be disruptive to patients and their families and place a strain on already limited healthcare resources. Moreover, repeated admissions could encourage dependency on inpatient services [7] and increase healthcare costs [5]. Therefore, readmission has long been recognized as a validated outcome measure for healthcare quality [8].…”

“…Therefore, readmission has long been recognized as a validated outcome measure for healthcare quality [8]. The commonly used timeframes to assess readmission were readmission within 30 days [3,5,7,9] and 1 year [2,7,10]. As for the frequency of readmissions, Langdon et al considered the patients that experienced three or more admissions a year to be "the revolving door" patients [11].…”

“…Previous studies have identified several factors associated with psychiatric readmissions, although some of these factors were found to be specific to settings and timeframes and the findings were somewhat mixed [5,7]. Literature review showed that the following factors have been examined: 1) Socio-demographic factors: patients' sex [4], age [11], marital status, insurance type, employment status, income level, care-giver information, living condition [12], education level and location of residency [5]; 2) Clinical factors: the previous service use [3], whether a patient was detained by law enforcement or was admitted involuntary [7], primary discharge diagnosis [13], illness severity (determined by various scales), various medical comorbidities [14], use of electroconvulsive therapy (ECT) [15], inpatient length of stay [16]; 3) Post-discharge factors: medication adherence [17], suicide attempts, family and social support, use of primary/ community healthcare services; 4) Hospital characteristics: the hospital type, size [15] and location [9].…”

Clinical risk model to predict 28-day unplanned readmission via the accident and emergency department after discharge from acute psychiatric units for patients with psychotic spectrum disorders

“…For the patient, being readmitted soon after discharge is disruptive to their recovery and, in the long run, is detrimental to the course of illness with poorer outcomes and may even engender dependency on psychiatric services. 1,2 Frequent readmissions put a strain on the family, the patient's social support network and lead to social stigma. 3 The staff may also feel demotivated over their confidence in the management of the patient.…”