Factors Associated with Psychiatric Readmissions: A Systematic Review

Abstract

Frequent Psychiatric Readmission (FPR) (revolving door phenomenon) is characterized by repeated and frequent hospitalizations that occur shortly after discharge. The aim was to analyze the criteria of FPR and associated factors: sociodemographic, clinic and care network data. We performed a systematic review in PubMed, VHL, and PsycINFO, using “readmission” and “mental disorder”. We selected empirical studies of adult populations, published in 2010-2014 in English,Portuguese and Spanish. Twenty-six articles were analyzed through the PRISMA protocol. High prevalence rates of FPR were found, between 9% (one month) and 84% (two years). Nevertheless, the different criteria used may have influenced contradictory results. The most consistent results indicate that young, single people, with less social support and involuntary admissions have higher chances of FPR, while community interventions seem to reduce FPR. We highlight the importance of establishing a consensus on the FPR criterion to develop future studies and interventions.

Living in psychosocial rehabilitation: analysis between Two Residential Therapeutic Services

“…It is worth noting that 40.54% of the population (n=30) were admitted only once to a psychiatric hospital, remaining institutionalized after that, under drug treatment and asylum practice. This situation corroborates the results of other studies 15-17 and refers to the discussion of the centrality of the asylum model in the care of the user with a severe mental disorder, associated with the fragility of operationalizing community-based and territorial care, with sufficient substitute services in Raps -characteristics of the Brazilian asylum model that has been gradually deconstructed with the Psychiatric Reform 18 .…”

A mirror-image analysis of psychiatric hospitalisations among people with severe mental illness using Independent Supported Housing

“…We further did not conduct regression analyses investigating factors related to the number and/or duration of hospitalisations. There is still great uncertainty on characteristics predicting hospitalisation use beyond clinical severity and crises [ 32 – 34 ]. Gaining insight into such predicting factors would help tailor ISH for even better prevention of psychiatric hospital admissions.…”

Internações psiquiátricas pelo Sistema Único de Saúde no Brasil ocorridas entre 2000 e 2014

“…A alta frequência de internações para um mesmo paciente pode ser enquadrada no fenômeno conhecido como porta giratória (revolving door), no qual o paciente apresenta várias internações com intervalos curtos de alta entre elas. Uma revisão sistemática verificou que o diagnóstico de esquizofrenia apresentava maior risco para reinternação 25 . Nesse sentido, a redução da taxa entre pacientes que internaram mais vezes pode estar associada à grande contração verificada na taxa de pacientes internados por esquizofrenia.…”