Readmissions to a General Hospital's Psychiatric Unit

Schanding, David; Siomopoulos, V.; Godbole, Anil; Smith, Moira

doi:10.1176/ps.35.2.170

Cited by 10 publications

(2 citation statements)

References 2 publications

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“…Zu den häufigsten Gründen für stationäre Wiederaufnahmen von heavy usern zählen Probleme im Zusammenhang mit der beruflichen Situation [2,20]. Heavy user sind zu 60 ± 80 % arbeitslos oder berentet [20,34,45] und unterscheiden sich damit hochsignifikant von Normalnutzern [14,19]. Dieses Überwiegen der Erwerbslosen unter den heavy usern könnte sich daraus erklären, dass noch erwerbstätige Patienten häufige stationäre Behandlungen aufgrund der damit verbundenen Fehlzeiten und der drohenden beruflichen Konsequenzen eher vermeiden.…”

Section: Soziodemographische Merkmaleunclassified

“…Die Terminologie ist dabei nicht einheit-lich, sondern reicht von ¹heavy user/utilizerª [1,2,4,13,15,16,23,24,49,69] über ¹high user/utilizerª [18, 21, 31, 70 ± 72], ¹frequent user/repeaterª [5,6,25,34], ¹high cost userª [73] bis zu ¹multipleª oder ¹worst recidivistª [8 ± 10]. Im Gegensatz dazu gibt es schon seit den 70er Jahren Untersuchungen zu den Ursachen und Prädiktoren stationärer Wiederaufnahmen [3,12,19,20,32,42,45,47,68,74,75 ± 78], zu ¹revolving door patientsª [30, 41, 79 ± 90] sowie zu ¹excessiveª, ¹intensivª oder ¹increased useª [22,91,92]. Darüber hinaus gibt es Parallelen zwischen heavy usern und ¹chronic crisis patientsª [93], ¹new chronic patientsª [94,95], ¹young adult chronicsª [96 ± 98] sowie ¹difficult to place psychiatric patientsª [99].…”

Section: Adäquatheit Der Inanspruchnahmeunclassified

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Heavy user psychiatrischer Versorgungsdienste

Roick¹,

Gärtner²,

Heider³

et al. 2002

Psychiatr Prax

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Section: Soziodemographische Merkmaleunclassified

Section: Adäquatheit Der Inanspruchnahmeunclassified

Heavy user psychiatrischer Versorgungsdienste

Roick¹,

Gärtner²,

Heider³

et al. 2002

Psychiatr Prax

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High risk factors for rehospitalization within six months

Walker¹,

Minor-Schork

Bloch

et al. 1996

Psych Quart

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Multifacility utilization by the chronically mentally ill in the department of veterans affairs

Durance

Gibson²,

Davis-Sacks

et al. 1992

The Journal of Mental Health Administration

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The objectives of this research are (1) to quantify the multifacility utilization patterns ("shared care") for a selected subset of patients with a chronic mental disorder, (2) to examine the patient characteristics correlated with several observed utilization patterns, and (3) to determine facility groups through cluster analysis, based on multifacility readmissions. Patients were identified from the VA's hospital discharge abstract system based on a diagnosis of schizophrenia in any discharge during the two-year study period. All discharges for this cohort during the period were analyzed. Essentially, three different groups of patients from this cohort were found. The vast majority have one or two hospitalizations and in the process are seen at one or maybe two facilities. However, two small minorities are hospitalized many times. One small group confines these hospitalizations to relatively few facilities while the other travels from facility to facility around the country. These two groups present very different clinical management problems from each other as well as from the majority. Since the distribution of travel distance between facilities remained similar for all types of patients (median distance was about 120 miles), facilities were clustered based on the number of linkages they shared. By use of six different measures of the disjointedness of shared care, clustering produced a reasonable number of meaningful groups which account for a majority of possibly uncoordinated shared care. We feel that these results and this approach can be useful for administrators, policymakers, and researchers. By looking simultaneously at the utilization patterns of its clients and their characteristics (e.g., age) as well as the utilization patterns within groups of facilities, any multifacility health system can characterize its shared care and identify those clients and facilities most in need of intervention, resources, and future study.

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Readmissions to a General Hospital's Psychiatric Unit

Cited by 10 publications

References 2 publications

Heavy user psychiatrischer Versorgungsdienste

Heavy user psychiatrischer Versorgungsdienste

High risk factors for rehospitalization within six months

Multifacility utilization by the chronically mentally ill in the department of veterans affairs

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