Exploring risk factors for re-hospitalization in a psychiatric inpatient setting: a retrospective naturalistic study

Abstract

Background The reduction of multiple psychiatric hospitalizations is an important clinical challenge in mental health care. In fact, psychiatric re-hospitalization negatively affects the quality of life and the life expectancy of patients with psychiatric disorders. For these reasons, identifying predictors of re-hospitalization is important for better managing psychiatric patients. The first purpose of the present study was to examine the readmission rate in a large sample of inpatients with a psychiatric disorder. Second, we investigated the role of several demographical and clinical features impacting re-hospitalization. Method This retrospective study enrolled 1001 adult inpatients (510 men and 491 women) consecutively admitted to the University Psychiatric Clinic, Sant'Andrea Hospital, Sapienza University of Rome between January 2018 and January 2022. To identify risk factors for psychiatric re-hospitalization, we divided the sample into 3 subgroups: the Zero-Re group which had no readmission after the index hospitalization, the One-Re group with patients re-admitted only once, and the Two-Re with at least two re-admissions. Results The groups differed according to previous hospitalizations, a history of suicide attempts, age at onset, and length of stay. Furthermore, the results of the regression model demonstrated that the Two-Re group was more likely to have a history of suicide attempts and previous hospitalizations. Discussion These results indicate the importance of assessing risk factors in psychiatric hospitalized patients and implementing ad hoc prevention strategies for reducing subsequent re-hospitalizations.

Identification of factors associated with hospitalization in an outpatient population with mental health conditions: a case–control study

“…However, the literature shows conflicting results. Some studies also confirm this risk factor, which has previously been identified in studies conducted in inpatient settings (18,24); in other studies, this risk factor was unclear, with nonsignificant results (11,21,25). The ability to have a job, which has been collected in our study with the variable "unskilled worker", has been identified as a protective factor in the multivariable logistic regression model (p-value: 0.006) adjusted for potential confounders, as illustrated in Table 2: aOR of 0.26 (95% CI: 0.10-0.65).…”

“…This risk factor has already been identified, particularly in schizophrenic patients ( 23 ). In another study, conducted without distinction of psychiatric pathology and still in an inpatient setting, no statistical association was found ( 18 ). Medical follow-up discontinuation in psychiatry has also already been studied in the literature.…”

“…For schizophrenia ( 14 , 15 ), recent medical follow-up discontinuation, medication nonadherence, life events, comorbidity, sex, age, and medication type were variables associated with hospitalization. Finally, for other psychiatric conditions ( 16 ) ( 9 , 10 ) ( 17 ) ( 11 ) ( 18 ), factors associated with hospitalization were shown to be recent medical follow-up discontinuation, multiple psychiatric hospitalization history, history of mental healthcare without consent, social isolation, socioeconomic status, violence history, psychiatric diagnosis, and patient’s satisfaction with treatment. A suicide attempt was found to be a risk factor for hospitalization in some studies and a protective factor at 1 year in others.…”

Psychiatric admissions in young people after expiration of criminal justice supervision in Australia: a retrospective data linkage study

“…Competing risk regression analyses based on Fine and Gray’s proportional subhazards model were used to identify predictors of psychiatric hospitalisation (with reincarceration as a competing event) 14. Potential confounding variables were selected a priori for inclusion in the regression analyses based on literature review of prior research 8 9 15–17. The following variables were included in the univariate analysis: sex, age at baseline, Indigenous status, index supervision status, parental incarceration, parental death, out-of-home care placement, previous incarceration, head injury, substance use disorder, psychosis, mood and anxiety disorder, personality disorder, behavioural disorder and intellectual and neurodevelopmental disorder.…”