Risk factors for rehospitalization and inpatient care among pediatric psychiatric intake response center patients

Tossone, Krystel; Jefferis, Eric; Bhatta, Madhav P.; Bilge-Johnson, Sumru; Seifert, Patricia C.

doi:10.1186/1753-2000-8-27

Cited by 29 publications

(40 citation statements)

References 39 publications

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“…[1][2][3][4][5][6][7] Os autores apontam como possí-veis explicações o bom e rápido suporte clínico e sociofamiliar após a alta hospitalar, os esforços para reavaliações pedopsiquiátricas frequentes e o importante trabalho de coordenação com instituições e serviços da comunidade, promovendo a inserção social e o apoio às famílias e permitindo a manutenção dos cuidados em ambulatório, prevenindo assim reinternamentos frequentes.…”

Section: Discussionunclassified

“…1,2 Estudos mais recentes referem taxas entre 30% a 50%. [3][4][5] Já as taxas de readmissão a 30 dias foram descritas entre 10% a 14%. 6,7 Vários fatores de risco para reinternamento psiquiátri-co em adultos têm sido relatados na literatura com resultados controversos, tais como: diagnóstico de perturbação psicótica ou perturbação da personalidade, baixa adesão ao tratamento, abuso de drogas, ausência de ocupação, pouco apoio familiar e antecedentes familiares de doença psiquiátrica.…”

Section: Introductionunclassified

“…6,7 Vários fatores de risco para reinternamento psiquiátri-co em adultos têm sido relatados na literatura com resultados controversos, tais como: diagnóstico de perturbação psicótica ou perturbação da personalidade, baixa adesão ao tratamento, abuso de drogas, ausência de ocupação, pouco apoio familiar e antecedentes familiares de doença psiquiátrica. 3,5,[7][8][9] Existem menos estudos sobre os fatores de risco de reinternamento em crianças e adolescentes, mas são apontados os seguintes: gravidade da patologia, 5,8 comportamento disruptivo ou graves problemas de conduta, 2,5 disciplina parental severa, 2 baixo envolvimento parental, 2 diagnóstico de perturbação do humor, 10 perturbação…”

Section: Introductionunclassified

“…Mendes P, et al Reinternamentos hospitalares num serviço de pedopsiquiatria, Acta Med Port 2017 Nov;30 (11): [769][770][771][772][773][774] psicótica ou de perturbação do comportamento alimentar (PCA), 5 institucionalização, 5,7 comportamentos suicidá-rios, 5,7 dificuldades de aprendizagem, 5 duração do internamento 8,9,11 e falta de cuidados pedopsiquiátricos adequados pós-alta. 3,5,8,10 A história de reinternamentos repetidos é o fator de risco mais consistente na literatura.…”

Section: Introductionunclassified

“…3,5,8,10 A história de reinternamentos repetidos é o fator de risco mais consistente na literatura. 3,[5][6][7][8] Um estudo realizado anteriormente nesta unidade de internamento (UI), então integrada no Hospital Central Especializado de Crianças Maria Pia, com a população de doentes internados entre 1999 e 2003 identificou os seguintes fatores de risco para reinternamento: diagnóstico de perturbação da personalidade, PCA ou perturbação psicótica e duração do internamento prévio superior a 30 dias (Teles A, Martins V, Guerra J, Fontes C, Rodrigues AC. Comunicação pessoal e apresentação de poster no XV Encontro Nacional de Psiquiatria da Infância e da Adolescên-cia).…”

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Reinternamentos Hospitalares num Serviço de Pedopsiquiatria: Taxa de Readmissão e Fatores de Risco

et al. 2017

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Several studies indicate that over 25% of child and adolescent inpatients were readmitted within one year of discharge. Several risk factors for psychiatric readmissions have been reported in the literature, but the history of repeated readmissions is the most consistent risk factor. Our aim is to calculate the readmission rates at 30 days and 12 months after discharge and to identify associated risk factors. Material and Methods:The authors consulted the clinical files of patients admitted to the Inpatient Unit between 2010 and 2013, in order to calculate the readmission rates at 30 days and at 12 months. The demographic and clinical characteristics of the readmitted patients were analyzed and compared with a second group of patients with no hospital readmissions, in order to investigate possible predictors of readmission. Results: A total of 445 patients were admitted to our inpatient unit between 2010 and 2013. Six adolescents were readmitted in a 30 days period (1.3%) and 52 were readmitted in a 12 month period after discharge (11.5%). Duration of the hospitalization and the previous number of mental health admissions were significant predictors of future hospital readmissions (p = 0.04 e p = 0.014). Discussion: The low readmission rates may reflect the positive clinical and sociofamilial support being provided after discharge. Conclusion: Rehospitalisation is considered a fundamental target for intervention concerning prevention and intervention in mental healthcare. Thus, knowledge regarding their minimisation is crucial. Keywords: Adolescent; Hospitalization; Mental Disorders; Patient Readmission; Portugal; Psychiatric Department, Hospital; Risk Factors INTRODUÇÃOA maioria das perturbações mentais tem uma evolução crónica, marcada por várias recaídas, pelo que alguns reinternamentos psiquiátricos são inevitáveis.1 Vários estudos indicam que mais de 25% das crianças e adolescentes internados foram readmitidos dentro de um ano após a alta.

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Section: Discussionunclassified

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Reinternamentos Hospitalares num Serviço de Pedopsiquiatria: Taxa de Readmissão e Fatores de Risco

et al. 2017

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Antipsychotic Treatment Among Youths With Attention-Deficit/Hyperactivity Disorder

et al. 2019

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Key Points Question How commonly are youths with attention-deficit/hyperactivity disorder treated with antipsychotic medications and what factors are associated with their use of antipsychotic treatment? Findings In this cohort study of 187 563 commercially insured youths with new episodes of attention-deficit/hyperactivity disorder, 2.3% were treated with an antipsychotic medication, among whom 52.7% had a potential clinical diagnostic rationale for antipsychotic treatment. Factors for antipsychotic medication use included older patient age, male sex, recent inpatient and other pharmacologic mental health treatments, self-harm/suicidal ideation; and oppositional defiant, substance use, depressive, and anxiety disorders. Meaning Approximately 1 in 40 commercially insured youths were treated with an antipsychotic medication without an approved indication in the year following a new attention-deficit/hyperactivity disorder diagnosis; mental health comorbidities may be associated with antipsychotic treatment in this group.

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Gender Specific Characteristics of Revolving Door Adolescents in Acute Psychiatric Inpatient Care

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Hakko

Riipinen

et al. 2017

Child Psychiatry Hum Dev

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This study examined the impact of clinical and family related factors on adolescent revolving door (RD) phenomenon, defined as having three or more psychiatric hospitalizations before the age of 18. A clinical sample of adolescents (N = 508) aged 13-17 years, admitted to psychiatric inpatient care between April 2001 through March 2006, were interviewed using the k-SADS-PL and the EuropASI instruments. The national Finnish Care Register for Health Care provided life-time data on child and adolescent psychiatric inpatient hospitalizations. RD boys were shown to be significantly more likely than non-RD boys to be admitted to psychiatric inpatient care from child welfare placements and have previous self-mutilative behavior (SMB) and suicide attempts. RD girls were more likely to come from child welfare placements, have unemployed mothers and a history of SMB. Mortality in RD boys was significantly higher compared to non-RD boys. Frequent use of psychiatric inpatient care warrants comprehensive assessment of suicidal behavior in adolescents.

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Risk factors for rehospitalization and inpatient care among pediatric psychiatric intake response center patients

Cited by 29 publications

References 39 publications

Reinternamentos Hospitalares num Serviço de Pedopsiquiatria: Taxa de Readmissão e Fatores de Risco

Reinternamentos Hospitalares num Serviço de Pedopsiquiatria: Taxa de Readmissão e Fatores de Risco

Antipsychotic Treatment Among Youths With Attention-Deficit/Hyperactivity Disorder

Gender Specific Characteristics of Revolving Door Adolescents in Acute Psychiatric Inpatient Care

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