Klinische und soziale Risikofaktoren für Wiederaufnahmen in die stationäre Psychiatrie bei Patienten mit Schizophrenie: Eine Langzeitanalyse

Warnke, Ingeborg; Nordt, Carlos; Ajdacic-Gross, Vladeta; Haug, Achim; Salize, Hans Joachim; Rössler, Wulf

doi:10.5414/nepband24243

Cited by 4 publications

(7 citation statements)

References 5 publications

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“…At bivariate level two articles on all patients with psychiatric disorders found a protective role for higher education (i.e., a higher risk of readmission for patients with primary education or illiteracy, and lower for those with university degree [57]; a low level of education turned out as a risk-increasing factor [36]), while one paper found a lower educational level as a protective factor for readmission [58]. The only significant association found in multivariate analysis (in one paper for subjects who were hospitalized involuntarily) highlighted that the number of years of education was associated with a decrease in readmission risk [61].…”

Section: Categories Of Pre-discharge Variables Analysedmentioning

confidence: 99%

“…In four studies a longer LoS turned out as a protective factor in multivariate analysis: toward readmission at 28–30 days for patients with different psychiatric diagnoses [34, 54], and at 4–5 years for patients respectively with substance use disorders or schizophrenia [21, 33]. Moreover, a longer LoS turned out as a protective factor also in three papers only performing bivariate analysis [36, 44, 57]. …”

Section: Categories Of Pre-discharge Variables Analysedmentioning

confidence: 99%

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Pre-discharge factors predicting readmissions of psychiatric patients: a systematic review of the literature

et al. 2016

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BackgroundReadmission rate is considered an indicator of the mental health care quality. Previous studies have examined a number of factors that are likely to influence readmission. The main objective of this systematic review is to identify the studied pre-discharge variables and describe their relevance to readmission among psychiatric patients.MethodsStudies on the association between pre-discharge variables and readmission after discharge with a main psychiatric diagnosis were searched in the bibliographic databases Ovid Medline, PsycINFO, ProQuest Health Management and OpenGrey. Relevant publications published between January 1990 and June 2014 were included. For each variable, the number of papers that considered it as a predictor of readmission and that found a significant association was recorded, together with the association direction and whether it was found respectively in bivariate and in multivariate analyses.ResultsOf the 734 articles identified in the search, 58 papers were included in this review, mainly from the USA and concerning patients with severe mental disorders. Analysed variables were classified according to the following categories: patients’ demographic, social and economic characteristics; patients’ clinical characteristics; patients’ clinical history; patients’ attitude and perception; environmental, social and hospital characteristics; and admission and discharge characteristics. The most consistently significant predictor of readmission was previous hospitalisations. Many socio-demographic variables resulted as influencing readmission, but the results were not always homogeneous. Among other patients’ clinical characteristics, diagnosis and measures of functional status were the most often used variables. Among admission characteristics, length of stay was the main factor studied; however, the results were not very consistent. Other relevant aspects resulted associated with readmission, including the presence of social support, but they have been considered only in few papers. Results of quality assessment are also reported in the review. The majority of papers were not representative of the general psychiatric population discharged from an inpatient service. Almost all studies used multivariate analytical methods, i.e., confounders were controlled for, but only around 60% adjusted for previous hospitalisation, the variable most consistently considered associated to readmission in the literature.ConclusionsThe results contribute to increase knowledge on pre-discharge factors that could be considered by researchers as well as by clinicians to predict and prevent readmissions of psychiatric patients. Associations are not always straightforward and interactions between factors have to be considered.Electronic supplementary materialThe online version of this article (doi:10.1186/s12888-016-1114-0) contains supplementary material, which is available to authorized users.

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Section: Categories Of Pre-discharge Variables Analysedmentioning

confidence: 99%

Section: Categories Of Pre-discharge Variables Analysedmentioning

confidence: 99%

Pre-discharge factors predicting readmissions of psychiatric patients: a systematic review of the literature

et al. 2016

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“…Das waren deutlich mehr als beispielsweise im Jahrgang 17 und 18 (2003 und 2004), in denen nur eine Originalarbeit [15] und keine Übersichtsarbeit zu diesem Thema identifiziert werden konnte. Lediglich zu einer einzigen Diagnosegruppe, nämlich den schizophrenen Psychosen, dem klassischen Feld psychiatrischer Forschung, fanden sich aktuell noch mehr Publikationen [16][17][18][19][20], wenn man die Arbeiten, die sich auf mehrere Krankheitsbilder beziehen, ausschließt. In der Psychiatrischen Praxis wurden vergleichsweise im Zeitraum 2009 und 2010 ebenfalls 8 von insgesamt 74 Arbeiten zur Demenz und zu leichten kognitiven Störungen publiziert (10,8 %).…”

Section: Diskussion !unclassified

“…In Europa lebten im Jahr 2000 etwa 7,1 Millionen Demenzkranke. Bis zum Jahr 2050 wird sich diese Zahl auf etwa 16 in 2 Originalarbeiten reflektiert [9,10]. Die medikamentöse Behandlung mit Memantine bei Verhaltensauffälligkeiten und psychotischen Symptomen hatte 1 Publikation im Fokus [11].…”

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Demenzerkrankungen – ein Thema für die psychiatrische Forschung?

Wancata¹

2011

Psychiat Prax

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“…Likewise, in Switzerland no study results are currently available regarding systematic discharge planning. However, Warnke et al [ 10 ] found that of 103 patients with a diagnosis of schizophrenia, about half were re-hospitalized within a year. Both clinical factors (such as not taking neuroleptic drugs), and social factors were associated with the risk of re-hospitalization.…”

Section: Introductionmentioning

confidence: 99%

Network coordination following discharge from psychiatric inpatient treatment: a study protocol

et al. 2013

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BackgroundInadequate discharge planning following inpatient stays is a major issue in the provision of a high standard of care for patients who receive psychiatric treatment. Studies have shown that half of patients who had no pre-discharge contact with outpatient services do not keep their first outpatient appointment. Additionally, discharged patients who are not well linked to their outpatient care networks are at twice the risk of re-hospitalization. The aim of this study is to investigate if the Post-Discharge Network Coordination Program at ipw has a demonstrably significant impact on the frequency and duration of patient re-hospitalization. Subjects are randomly assigned to either the treatment group or to the control group. The treatment group participates in the Post-Discharge Network Coordination Program. The control group receives treatment as usual with no additional social support. Further outcome variables include: social support, change in psychiatric symptoms, quality of life, and independence in daily functioning.Methods/designThe study is conducted as a randomized controlled trial. Subjects are randomly assigned to either the control group or to the treatment group. Computer generated block randomization is used to assure both groups have the same number of subjects. Stratified block randomization is used for the psychiatric diagnosis of ICD-10, F1. Approximately 160 patients are recruited in two care units at Psychiatrie-Zentrum Hard Embrach and two care units at Klinik Schlosstal Winterthur.DiscussionThe proposed post-discharge network coordination program intervenes during the critical post-discharge period. It focuses primarily on promoting the integration of the patients into their social networks, and additionally to coordinating outpatient care and addressing concerns of daily life.Trial registrationISRCTN: ISRCTN58280620

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Klinische und soziale Risikofaktoren für Wiederaufnahmen in die stationäre Psychiatrie bei Patienten mit Schizophrenie: Eine Langzeitanalyse

Cited by 4 publications

References 5 publications

Pre-discharge factors predicting readmissions of psychiatric patients: a systematic review of the literature

Pre-discharge factors predicting readmissions of psychiatric patients: a systematic review of the literature

Demenzerkrankungen – ein Thema für die psychiatrische Forschung?

Network coordination following discharge from psychiatric inpatient treatment: a study protocol

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