Readmission: A useful indicator of the quality of inpatient psychiatric care

Introduction:The revolving door phenomenon is characterized by repeated and frequent psychiatric readmissions. Objective: We aim to investigate sociodemographic, clinic, and follow-up characteristics in health services associated to psychiatric admissions and readmissions of inpatients in a general hospital of Porto Alegre. Methods: It is a cross-sectional study with a sample of 96 participants. Results: More than half of the sample (53.1%) were female, 51% were single, and the average age was 44.3 years old. From clinic data, 36% (n = 35) of the users were in their first admission, and 36% (n = 35) met the criteria for frequent readmission. The results show that users with frequent readmissions significantly mentioned fewer people on whom they could rely. Alternatively, users in first admission lived with a significant larger number of people than the rest of the sample and had, with less frequency, bond with health services other than hospitals, using hospitals as an entrance door to mental health care. Regarding follow-up in the network, 34.4% of the sample did not visit often NPC services before admission, and only 4.1% used psychosocial rehabilitation services. Conclusion: We highlight the importance of hospitals as an articulation point in the network, and as strategic to connect with NPC services. In spite of international literature investigation and registration of the frequent psychiatric readmission phenomenon, we notice it is a field that needs greater investigation in Brazil.

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“…younger users 16,17 ; 2. single or living by themselves 5,12,[18][19][20][21] ; and 3. those who have less contact with their families 19,22,23 .…”

Section: Palavrasmentioning

confidence: 99%

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

Zanardo

Silveira

Rocha

et al. 2017

Rev. bras. epidemiol.

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“…Rehospitalization has been utilized as an indicator of whether social networks will accept mentally ill patients and, more recently, as an indicator of the quality of health services. However, there is no consensus on the reliability of this parameter for measuring the quality of care [1,6,8]. …”

Section: Introductionmentioning

confidence: 99%

“…Determining the factors that contribute to the rehospitalization phenomenon may assist in the development of programs and policies to prevent rehospitalization, improve patient care and quality of life, as well as reduce the costs of care, especially in care models with reduced availability of beds and greater restrictions for caring for mentally ill patients [7,8,13]. …”

Section: Introductionmentioning

confidence: 99%

The frequency of rehospitalization and associated factors in Colombian psychiatric patients: a cohort study

Jaramillo-González

Sánchez-Pedraza

Herazo³

2014

BMC Psychiatry

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BackgroundThe rehospitalization of patients with mental disorders is common, with rehospitalization rates of up to 80% observed in these patients. This phenomenon negatively impacts families, patients, and the health care system. Several factors have been associated with an increased likelihood of rehospitalization. This study was aimed at determining the frequency and the factors associated with rehospitalization in a psychiatric clinic.MethodsWe performed a prospective cohort study with 361 patients who were hospitalized at the Clinic of Our Lady of Peace in Bogota, Colombia from August-December 2009. We calculated the incidence rates of rehospitalization and the risk factors using Cox regression.ResultsOverall, 60% of the patients in this cohort were rehospitalized during the year that followed the index event. The variables associated with rehospitalization were separated, divorced, or single status; higher socio-economic strata; a longer duration of index hospitalization; and a diagnosis of substance abuse, schizophrenia, bipolar disorder, or depression.ConclusionsThe rehospitalization rate in our study was as high as reported in other studies. The associated factors with it in this group, may contribute to the design of programs that will reduce the frequency of rehospitalization among patients with mental disorders, in countries like Colombia. Additionally, these results may be useful in interventions, such as coping skills training, psycho-education, and community care strategies, which have been demonstrated to reduce the frequency of rehospitalization.

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“…Similar to longer follow-up periods, previous hospitalization is a robust predictor of acute inpatient readmissions (Monnelly, 1997;Swett, 1995;Zilber et al, 2011). Additional factors include less depression improvement during hospitalization (Byrne et al, 2010), greater instability before discharge (Monnelly, 1997), and more severe thought disorder symptoms (Swett, 1995). Of note, most of these studies focused on one specific variable of interest, rather than examining a full range of sociodemographic and clinical variables simultaneously.…”

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confidence: 99%

When Partial Hospitalization Fails

et al. 2016

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Partial hospitalization is an understudied bridge between outpatient and inpatient care. One of its primary functions is to prevent the need for inpatient hospitalization. We examined potential demographic and clinical risk factors for inpatient hospitalization for current partial hospital patients. We conducted separate multiple logistic regression analyses for patients referred from inpatient care and the community. For individuals referred from inpatient care, suicidal ideation and greater psychotic symptoms upon admission to the partial program were associated with acute inpatient re-hospitalization. For individuals referred from the community, suicidal ideation and worse relationship functioning upon partial hospital admission were significant risk factors for inpatient hospitalization. Number of previous inpatient hospitalizations and greater substance abuse were not associated with inpatient hospitalization in either sample. Implications at the provider and program level are discussed.

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Readmission: A useful indicator of the quality of inpatient psychiatric care

Cited by 61 publications

References 14 publications

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

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

The frequency of rehospitalization and associated factors in Colombian psychiatric patients: a cohort study

When Partial Hospitalization Fails

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