Hospital and patient factors influencing the health status among patients with schizophrenia, thirty days after hospital discharge: multi-level analysis

Abstract

Background The time between discharge from hospital and transition to community and home is a critical period for health status among patients with a mental illness, including patients with schizophrenia. This study aimed to investigate crucial patient factors (patient-level) and hospital factors (hospital-level) affecting health status and see whether patient factor effects on health status vary with hospital factors, 30 days after hospital discharge. Methods This is a prospective study of 1255 patients with schizophrenia and their primary caregivers from 13 public mental hospitals across Thailand. Logistic regression and multi-level logistic regression was used to investigate the effects of patient and hospital factors simultaneously on health status, 30 days after hospital discharge. Results The intraclass correlation coefficient indicated that 14% of the change in health status was explained by the differences between hospital. Poor health status was identified in 14.26% of patients, 30 days after hospital discharge. The majority of participant patients were male (69.8%), single (71.87%), and the average age was 38.09 (SD = 9.74). The finding also showed that the patient factors; being female (ORadj .53, 95%CI .31,.92), perceived moderate and high levels of positive aspect of caregiving (ORadj .24, 95%CI .14,.42 and ORadj .05, 95%CI .02,.09), perceived readiness for hospital discharge (ORadj .21, 95%CI .13,.33), partial and full adherence to treatment (ORadj .24, 95%CI .14,.42 and ORadj .31, 95%CI .20,.47) showed a reduced likelihood of developing poor health status except substance use (ORadj 1.55, 95%CI .98, 2.44). Hospital factors; discharge planning process and nurse-patient ratio (ORadj 1.64, 95%CI 1.17, 2.30 and ORadj 1.16, 95%CI 1.09, 1.22) showed an increased likelihood of developing poor health status, 30 days after hospital discharge. Conclusions Findings provide relevant information on how both patient and hospital factors determine health status. These results might lead to better targeting of mental health service policy and enable more precise information gathering and allocation of resources. However, future research should be more focused and continue investigating the pathways through which hospital factors influence health status post-discharge.

Status Quo and Influencing Factors of Discharge Readiness of Patients with Bilateral Ureteral Stoma After Radical Cystectomy

“…Discharge at this time would increase the pressure of discharge of patients. Therefore, nursing staff should do a good job in the discharge evaluation of planned discharged patients, especially those with poor discharge readiness, to further reduce the readmission rate of patients and improve the discharge readiness of patients ( 14 , 15 ).…”

“…Discharge at this time would increase the pressure of discharge of patients. Therefore, nursing staff should do a good job in the discharge evaluation of planned discharged patients, especially those with poor discharge readiness, to further reduce the readmission rate of patients and improve the discharge readiness of patients (14,15). QDTS are widely used to evaluate whether patients perceive the teaching ability of nursing and thereby verify the discharge education skills of the nurses, which was demonstrated to have high reliability with modification to Chinese version (16,17).…”

The needs of carers who support people living with schizophrenia and a substance use disorder: a multiperspective evaluation

“…Carers can have both positive and negative impacts on the evolution of a PLS-SUD. On the positive side, they can increase the PLS-SUD’s motivation to change their substance use practises (Maisto et al , 1999; Rebgetz et al , 2016; Tracy and Biegel, 2006), promote the satisfaction of their basic needs, which leads to a global improvement in health (Clark, 2001; Labrum, 2020; Townsend et al , 2006), facilitate access to care (Huguelet et al , 2012; Schofield et al , 2001; Tracy and Biegel, 2006) and, in the case of hospitalization, help with reintegration into the community (Smithnaraseth et al , 2020).…”

Organizational profiles and personal factors affecting Health-related quality of life among older persons diagnosed with depressive disorders: path analysis and GEE

“…The characteristics of the hospital include the level of hospital, number of health manpower, facilities of the hospital, etc. They were rarely associated with health outcomes as a result of little variation in hospital characteristics [13,14]. Also, the level of the hospitals including psychiatric hospitals, regional hospitals, general hospitals, and community hospitals did not show the effect of improving HRQoL differently in patients with DD who received mental service in the rst three months [13].…”