Serious mental illness, other mental health disorders, and outpatient health care as predictors of 30-day readmissions following medical hospitalization

Cook, Judith Α.; Burke-Miller, Jane K.; Razzano, Lisa A.; Steigman, Pamela J.; Jonikas, Jessica A.; Santos, Alberto B.

doi:10.1016/j.genhosppsych.2021.02.004

Cited by 8 publications

(6 citation statements)

References 45 publications

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“…While it was possible in our study to adjust for several potential confounders (gender, age, psychotic disorder, physical comorbidity, LOS), an association between early outpatient contacts and subsequent re‐hospitalisation rates might, for instance, have been mediated by the severity of the disorder, on which we had no information. A lower severity of the illness at baseline could have been related to both, a higher ability to access services and a reduced re‐hospitalisation rate (Cook et al., 2021 ). In an Australian study patients who received follow‐up care by the area mental health team within 7 days of discharge were more likely to be readmitted, and the authors suggest that patients who were selected by the mental health team for early contacts were already judged to be at greater risk of early readmission (Callaly et al., 2011 ).…”

Section: Discussionmentioning

confidence: 99%

“…While in other medical fields, for instance in pharmacoepidemiology (Acton et al., 2023 ; Suissa & Dell’Aniello, 2020 ) or in oncology (Heemskerk‐Gerritsen et al., 2019 ) awareness for time‐dependent biases is growing, this is not the case in the field of psychiatric re‐hospitalisation studies. Two studies examining the association between early post‐discharge contacts and the 30‐day psychiatric re‐hospitalisation rate, that is, the time period regarded increasingly as crucial as a quality indicator, did not—according to the description of their methods—consider the ‘immortal time bias’ and used standard multiple logistic or Cox regression with post‐discharge contacts as independent variable regarded as having been present at baseline (Cook et al., 2021 ; Huff, 2000 ).…”

Section: Introductionmentioning

confidence: 99%

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Are early post‐discharge physician contacts associated with 30‐day psychiatric re‐hospitalisation? A nationwide claims data based retrospective cohort study in Austria free of immortal time bias

Katschnig,

Straßmayr,

Endel

et al. 2023

Int J Methods Psych Res

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ObjectivesCost containment and quality of care considerations have increased research interest in the potential preventability of early re‐hospitalisations. Various registry‐based retrospective cohort studies on psychiatric re‐hospitalisation have focused on the role of early post‐discharge service contacts, but either did not consider their time‐dependent nature (‘immortal time bias’) or evaded the issue by analysing late re‐hospitalisations. The present study takes care of the immortal time bias in studying early psychiatric re‐hospitalisations.MethodsIn a retrospective cohort study using nationwide electronic claims data in Austria, 10,689 adults discharged from acute psychiatric inpatient wards were followed up for 30 days. Cox regression analyses were performed with post‐discharge psychiatric and general practitioner contacts as time‐dependent covariates and time to first psychiatric re‐hospitalisation as outcome.ResultsPost‐discharge ambulatory physician contacts were significantly associated with a decreased psychiatric re‐hospitalisation rate (hazard ratio 0.77 [95% CI 0.69; 0.87], p < 0.0001), with similarly strong contributions to this association by general practitioners and psychiatrists.ConclusionsDespite avoiding the immortal time bias and controlling for several confounders, we suggest to be cautious with a causal interpretation of the identified association, since potentially relevant confounders, such as disease severity, were unavailable in our claims data base.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Are early post‐discharge physician contacts associated with 30‐day psychiatric re‐hospitalisation? A nationwide claims data based retrospective cohort study in Austria free of immortal time bias

Katschnig,

Straßmayr,

Endel

et al. 2023

Int J Methods Psych Res

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“…Individuals with SMI and OMH are overrepresented in the Medicaid population, while both have high hospital readmission rates. Individuals utilizing outpatient services are protected against higher readmission rates with a decrease in the length of inpatient stays, substance use, and other comorbid conditions (Cook et al, 2021). Benjenk et al (2020) reported that 21% of the adults who are Medicaid bene ciaries had a mental illness, 26% were diagnosed with a serious mental illness, while the general population was 14% (Benjenk et al, 2020).…”

Section: Literature Reviewmentioning

confidence: 99%

An Exploratory Factor Analysis of the Oblique Hope, Affectivity, Resiliency, and Empathy (O-HARE) Questionnaire

Wahl¹

2022

Preprint

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An exploratory factor analysis (EFA) was used to evaluate a 54-item experimental questionnaire called the Oblique Hope, Affectivity, Resiliency, and Empathy (O-HARE). The sample was N = 181 adults in the United States who have experienced mental health concerns during their lifetime. Individuals were randomly assigned to a control condition (n = 95) and experimental condition (n = 86). Three instruments were administered online, O-HARE, NEO Five-Factor Inventory, and the Personality Assessment Screener. There was no significant effect size between the two conditions (d = .212). Factor loading using a Promax principal component rotation with coefficient's suppressed (< 0.40) indicated the O-HARE had a significant KMO = 89.8, p = .001 on 12 factors. The EFA produced low factor loadings for 18 items, a reduction to 36 items on seven factors increased the KMO = 92.3, p = .001. The four O-HARE domains had significant t-scores with p values < .001. ANOVA demonstrated a strong relationship between the NEO-FFI-3, O-HARE, and PAS subscales. The t-scores were significant, with p values < .001 on all NEO-FFI-3 dimensions and PAS subscales.

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“…However, most literature supports the primary issues related to psychiatric readmissions after psychiatric hospitalization. Cook et al (2021) examined 30-day predictors of readmission following medical hospitalization for individuals experiencing either a serious mental illness, other mental health disorder, or outpatient health care. The sample consisted of a total of N = 43,817 Medicaid bene ciaries between 18 and 64 years old.…”

Section: Literature Reviewmentioning

confidence: 99%

“…Individuals with SMI and OMH are overrepresented in the Medicaid population, while both have high hospital readmission rates. Individuals utilizing outpatient services are protected against higher readmission rates with a decrease in the length of inpatient stays, substance use, and other comorbid conditions (Cook et al, 2021). Benjenk et al (2020) reported that 21% of adults who are Medicaid bene ciaries had a mental illness, 26% were diagnosed with a serious mental illness, and the general population was 14% (Benjenk et al, 2020).…”

Section: Literature Reviewmentioning

confidence: 99%

An Exploratory Factor Analysis of the Oblique Hope, Affectivity, Resiliency, and Empathy (O-HARE) Questionnaire

Wahl¹,

Nerone²,

Weintraub³

2022

Preprint

View full text Add to dashboard Cite

An exploratory factor analysis (EFA) was used to evaluate a 54-item experimental questionnaire called the Oblique Hope, Affectivity, Resiliency, and Empathy (O-HARE). The sample was N = 181 adults in the United States who had experienced mental health concerns during their lifetime. Individuals were randomly assigned to a control condition (n = 95) and experimental condition (n = 86). Three instruments were administered online: O-HARE, NEO Five-Factor Inventory, and the Personality Assessment Screener. There was no significant effect size between the two conditions (d = .212). Factor loading using a Promax principal component rotation with coefficient's suppressed (< 0.40) indicated the O-HARE had a significant KMO = 89.8, p= .001 on 12 factors. The EFA produced low factor loadings for 18 items, and a reduction to 36 items on seven factors increased the KMO = 92.3, p = .001. The four O-HARE domains had significant t-scores with p values <.001. ANOVA demonstrated a strong relationship between the NEO-FFI-3, O-HARE, and PAS subscales. The t-scores were significant, with p values <.001 on all NEO-FFI-3 dimensions and PAS subscales.

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Serious mental illness, other mental health disorders, and outpatient health care as predictors of 30-day readmissions following medical hospitalization

Cited by 8 publications

References 45 publications

Are early post‐discharge physician contacts associated with 30‐day psychiatric re‐hospitalisation? A nationwide claims data based retrospective cohort study in Austria free of immortal time bias

Are early post‐discharge physician contacts associated with 30‐day psychiatric re‐hospitalisation? A nationwide claims data based retrospective cohort study in Austria free of immortal time bias

An Exploratory Factor Analysis of the Oblique Hope, Affectivity, Resiliency, and Empathy (O-HARE) Questionnaire

An Exploratory Factor Analysis of the Oblique Hope, Affectivity, Resiliency, and Empathy (O-HARE) Questionnaire

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