Predictors for readmission risk of new patients: the Nordic Comparative Studyon Sectorized Psychiatry

Øiesvold, Terje; Saarento, O; Sytema, Sjoerd; Vinding, H R; Göstas, G; Lönnerberg, O; Muus, S; Sandlund, Mikael; Hansson, L

doi:10.1034/j.1600-0447.2000.101005367.x

Cited by 55 publications

(46 citation statements)

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“…Although several studies have emphasized the importance of aftercare and follow-up services, other studies have not found a relationship between readmission rates and the presence of aftercare (18,19), patients' attitudes toward follow-up (20), or continuity of therapists (21). Despite extensive study of the factors associated with community tenure, the factors that predict successful community living after inpatient care are still only partly understood.…”

Section: Effects Of Patient and Health-system Characteristics On Commmentioning

confidence: 99%

Effects of Patient and Health-System Characteristics on Community Tenure of Discharged Psychiatric Inpatients

Bruffærts¹,

Sabbé²,

Demyttenaere³

2004

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6 68 85 5 O ver the past two decades, the organization and provision of mental health care have changed dramatically. The deinstitutionalization of mental health services has resulted in shorter stays in psychiatric hospitals and in larger numbers of psychiatric patients living in the community (1). Many communities have too few resources to help these patients (2). The number of psychiatric referrals to hospital emergency departments has increased, partly because of the general lack of linkage between institutional and community services (3). This trend has been observed both in the United States and in Europe (4).Previous research has provided consistent evidence that persons with previous use of psychiatric services are among the most frequent users of psychiatric emergency departments (5-10). Moreover, patients who are readmitted to inpatient psychiatric care are often found to have been recently discharged from a psychiatric hospitalization. In previous studies, 24 percent of 262 patients (11) and 38 percent of 128 patients (12) with a recent hospital discharge were readmitted within three to six months. In a study of state hospital patients in Massachusetts, Fisher and colleagues (13) found a 50 percent readmission rate within four years of discharge among 5,610 patients. Early hospital readmission has been related to the presence of mental illnesses with poor prognoses (13-15), to poor quality of patients' social networks, and to patients' difficulties with hygiene at discharge (16).Early readmissions, however, may also reflect the quality of postdischarge treatment and care. Some unplanned psychiatric referrals could be explained by the unexpected and acute progression of the patient's mental illness, but the rest may result because the mentally ill person has been discharged from the hospital too soon or because follow-up in the community is ineffective.Lower readmission rates have been associated with the existence of follow-up services. For example, McIntosh and Worley (17) implemented telephone follow-up and aftercare groups for patients who were discharged from a psychiatric hospitalization. Fifteen months after the implementation of these services, these authors found a readmission rate of

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Section: Effects Of Patient and Health-system Characteristics On Commmentioning

confidence: 99%

Effects of Patient and Health-System Characteristics on Community Tenure of Discharged Psychiatric Inpatients

Bruffærts¹,

Sabbé²,

Demyttenaere³

2004

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“…6,8,11 Alguns estudos apontam como fator de risco o internamento prolongado, embora apontem como viés a maior gravidade da patologia. [14][15][16][17][18] Por outro lado, internamentos de curta duração também foram associados a um maior risco de internamento pelo risco de não se ter atingido a estabilização da doença aquando da alta.…”

Section: Discussionunclassified

Reinternamentos Hospitalares num Serviço de Pedopsiquiatria: Taxa de Readmissão e Fatores de Risco

et al. 2017

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Several studies indicate that over 25% of child and adolescent inpatients were readmitted within one year of discharge. Several risk factors for psychiatric readmissions have been reported in the literature, but the history of repeated readmissions is the most consistent risk factor. Our aim is to calculate the readmission rates at 30 days and 12 months after discharge and to identify associated risk factors. Material and Methods:The authors consulted the clinical files of patients admitted to the Inpatient Unit between 2010 and 2013, in order to calculate the readmission rates at 30 days and at 12 months. The demographic and clinical characteristics of the readmitted patients were analyzed and compared with a second group of patients with no hospital readmissions, in order to investigate possible predictors of readmission. Results: A total of 445 patients were admitted to our inpatient unit between 2010 and 2013. Six adolescents were readmitted in a 30 days period (1.3%) and 52 were readmitted in a 12 month period after discharge (11.5%). Duration of the hospitalization and the previous number of mental health admissions were significant predictors of future hospital readmissions (p = 0.04 e p = 0.014). Discussion: The low readmission rates may reflect the positive clinical and sociofamilial support being provided after discharge. Conclusion: Rehospitalisation is considered a fundamental target for intervention concerning prevention and intervention in mental healthcare. Thus, knowledge regarding their minimisation is crucial. Keywords: Adolescent; Hospitalization; Mental Disorders; Patient Readmission; Portugal; Psychiatric Department, Hospital; Risk Factors INTRODUÇÃOA maioria das perturbações mentais tem uma evolução crónica, marcada por várias recaídas, pelo que alguns reinternamentos psiquiátricos são inevitáveis.1 Vários estudos indicam que mais de 25% das crianças e adolescentes internados foram readmitidos dentro de um ano após a alta.

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“…A validade de tal procedimento como medida de qualidade do cuidado hospitalar é, muitas vezes, questionada, principalmente porque foi um indicador desenvolvido nos Estados Unidos, e nem sempre um modelo adequado para um tipo de sistema de saúde pode servir para outro que possui funcionamento distinto (Fischer et al, 2012 (Oiesvold et al, 2000;Hodgson et al, 2001;Lin et al, 2010). A associação desses fatores na área da psiquiatria é bem significativa, já que também existem dificuldades determinadas pelo próprio transtorno mental (Roick et al, 2004).…”

Section: Reinternações Psiquiátricasunclassified

“…As reinternações psiquiátricas também se associam positivamente com características de internações anteriores, como maior tempo de internação (Lin et al, 2010), maior quantidade de internações anteriores (Gerolamo, 2004;de Castro, Furegato & Santos, 2010;Wheeler et al, 2011;Zhang et al, 2011), tipo de alta (de Castro et al, 2010), internação involuntária (Hodgson et al, 2001) e falta de programação do seguimento pós-alta durante a internação (Oiesvold et al, 2000).…”

Section: Reinternações Psiquiátricasunclassified

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Identificação de fatores associados à aderência ao tratamento, reinternação hospitalar e necessidades de cuidados de pacientes inseridos na rede pública de assistência em saúde mental

Santos¹

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AgradecimentosAos meus pais, Marcia e Vilson, pela educação que me deram e que me fez um ser humano honesto, justo e com vontade de saber sempre mais.Ao meu marido Vanderlei, por todo apoio nesta jornada, nem sempre tão fácil de ser compreendida por quem não é da área médica e científica. Sempre me ajudou e apoiou, simplesmente por acreditar que era importante.À minha amada filha, Ana Júlia, que sempre teve orgulho de uma mãe estudante, e que se deliciava quando eu também tinha que fazer "lição de casa". Principalmente a ela, que eu seja um exemplo de que nunca devemos parar.Aos demais familiares, Gra, tia Gó, Dani, e todos os outros com quem tenho uma dívida emocional, por estarem comigo, não só neste, mas em todos os momentos importantes da minha vida.À Profa. Dra. Cristina Marta Del-Ben, minha amiga Kit, que, por me incentivar fortemente a fazer doutorado, tornou-se também minha orientadora, papel que exerceu como uma verdadeira cientista (que é!). Aprendi muito com você e tenho certeza de que vou aprender sempre, pois o doutorado se finda, mas amigos não saem de nossas vidas.

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Predictors for readmission risk of new patients: the Nordic Comparative Studyon Sectorized Psychiatry

Abstract: Our findings support a hypothesis that readmission risk is multifactorially determined and that interactions have to be considered.

Cited by 55 publications

References 0 publications

Effects of Patient and Health-System Characteristics on Community Tenure of Discharged Psychiatric Inpatients

Effects of Patient and Health-System Characteristics on Community Tenure of Discharged Psychiatric Inpatients

Reinternamentos Hospitalares num Serviço de Pedopsiquiatria: Taxa de Readmissão e Fatores de Risco

Identificação de fatores associados à aderência ao tratamento, reinternação hospitalar e necessidades de cuidados de pacientes inseridos na rede pública de assistência em saúde mental

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