Predictors of psychiatric readmissions in the short- and long-term: a population-based study in taiwan

Abstract

OBJECTIVESTo explore the risks and rates of readmission and their predictors 14 days, one year, and five years after discharge for the psychiatric population in Taiwan.METHODSThis was a prospective study based on claims from 44,237 first-time hospitalized psychiatric patients discharged in 2000, who were followed for up to five years after discharge. The cumulative incidence and incidence density of readmission were calculated for various follow-up periods after discharge, and Cox proportional hazard models were generated to identify the significant predictors for psychiatric readmission.RESULTSThe less than 14-day, one-year, and five-year cumulative incidences were estimated at 6.1%, 22.3%, and 37.8%, respectively. The corresponding figures for incidence density were 4.58, 1.04, and 0.69 per 1,000 person-days, respectively. Certain factors were significantly associated with increased risk of readmission irrespective of the length of follow-up, including male gender, length of hospital stay >15 days, economic poverty, a leading discharge diagnosis of schizophrenia/affective disorders, and residence in less-urbanized regions. Compared to children/adolescents, young adults (20–39 years) were significantly associated with increased risks of <one-year and <five-year readmissions, but not <14-day readmission. Additionally, hospital characteristics were significantly associated with increased risk of <14-day and <one-year readmission, but not with risk of <five-year readmission.CONCLUSIONSThis study found that the significant predictors for psychiatric readmission 14 days to five years after discharge were essentially the same except for patient’s age and hospital accreditation level. This study also highlighted the importance of socioeconomic factors in the prediction of readmission.

Internações e reinternações psiquiátricas em um hospital geral de Porto Alegre: características sociodemográficas, clínicas e do uso da Rede de Atenção Psicossocial

“…The mean age of the sample was 44.33 years, which is in agreement to other studies which presented mean higher than 37 years of age 7,11,16,20,21,24,33,34 . The findings of the present study did not show association between age and frequent readmissions, results corroborated by some studies in the area 24,33,34 .…”

“…The findings of the present study did not show association between age and frequent readmissions, results corroborated by some studies in the area 24,33,34 . In regard to gender, a slightly higher number of women (53.1%) may be observed in the sample.…”

“…In relation to this profile, it may be highlighted it is in the same direction of other studies indicating most participants had secondary levels of study or low education 7,8,[18][19][20] . This was not a variable to present differences when compared to the frequent readmission group, which corroborates the literature 33,34 . In relation to marital status, most participants in this study did not have a companion (77.1%), which is in agreement to other researches showing a predominance of participants without partners in their samples [7][8][9]21,24 .…”

“…In regard to gender, a slightly higher number of women (53.1%) may be observed in the sample. Although no significant difference was found in the group of frequent readmissions, the percentage of men (54.3%) was higher, while only 34.6% were men in the group of non-frequent users, which corroborates some studies in the literature which indicate gender as a significant variable, in which men had higher numbers and chances of readmissions 18,19,20,34 . The mean education in the sample was of 9.29 years, which indicates that most (46.9%) participants attended high school.…”

Indicadores de reinternação em enfermaria de psiquiatria

“…Tais readmissões são consideradas precoces e negativas 6,7 . Estudos recentes observaram os seguintes preditores como os mais relevantes para reinternação psiquiátrica: não adesão à medicação, uso de substâncias psicoativas e eventos de vida traumáticos 8 Resultados apresentados como média ± desvio padrão ou n (%).…”