Readmission rates of South Korean psychiatric inpatients by inpatient volumes per psychiatrist

Abstract

BackgroundReadmission rates of psychiatric inpatients are higher in South Korea than other Organization for Economic Co-operation and Development (OECD) countries. In addition, the solution for readmission control is deficient based on the characteristics of the South Korean National Health Insurance (NHI) system. Therefore, it is necessary to identify ways to reduce psychiatric inpatient readmissions. This study investigated the relationship between inpatient volume per psychiatrist and the readmission rate of psychiatric inpatients in South Korea.MethodWe used NHI claim data (N = 37,796) from 53 hospitals to analyze readmission within 30 days for five diagnosis (organic mental disorders, mental and behavioral disorders due to psychoactive substance use, schizophrenia, mood disorders, neurotic disorders, and stress-related and somatoform disorders) between 2010 and 2013. We performed χ2 and analysis of variance tests to investigate associations between patient and hospital-level variables and readmission within 30 days. Finally, generalized estimating equation (GEE) models were analyzed to examine possible associations with readmission.ResultsReadmissions within 30 days accounted for 1,598 (4.5 %) claims. Multilevel analysis demonstrated that inpatient volume per psychiatrist were inversely related with readmission within 30 days (low odds ratio [OR]: 0.38, 95 % confidence interval [CI]: 0.28–0.51; mid-low OR: 0.48, 95 % CI: 0.36–0.63; mid-high OR: 0.55, 95 % CI: 0.44–0.69; Q4 = ref). The subgroup analysis by diagnosis revealed that both “schizophrenia, schizotypal, and delusional disorders” and “mood disorders” had inverse relationships with readmission risk for all volume groups.ConclusionsWe observed an inverse association between inpatient volume per psychiatrist and the 30-day readmission rate of psychiatric inpatients, suggesting that it could be a useful quality indicator in mental health care.

Factors associated with 30-day and 1-year readmission among psychiatric inpatients in Beijing China: a retrospective, medical record-based analysis

“…The 30-day readmission rate (16.69%) in this study was consistent with some studies conducted in other countries and settings [7,9]; nevertheless, the 30-day readmission rate had large variations from previous reports. A report published by the Organization for Economic Cooperation and Development suggested that the 30-day readmission rate for schizophrenia varied from 5 to 20% among 20 countries [39] and the 30-day readmission rate was 4.5% (1598/37,796) in a Korean sample [8]. The 1-year readmission rate (33.79%) in our study is similar to that reported in other studies [10,40] except the one reported by Zhou el al.…”

“…Moreover, repeated admissions could encourage dependency on inpatient services [7] and increase healthcare costs [5]. Therefore, readmission has long been recognized as a validated outcome measure for healthcare quality [8]. The commonly used timeframes to assess readmission were readmission within 30 days [3,5,7,9] and 1 year [2,7,10].…”

Association of high psychiatrist staffing with prolonged hospitalization, follow-up visits, and readmission in acute psychiatric units: a retrospective cohort study using a nationwide claims database

“…To the best of our knowledge, there are only two studies on this issue in the field of psychiatric inpatient care. 6 , 7 A cross-sectional study of 673 patients in 25 hospitals across 11 countries found that lower patient-to-psychiatrist ratio (high staffing) was associated with higher treatment satisfaction (percentage of patients with low satisfaction: 18% in high-staffing hospitals and 40% in low-staffing hospitals). 6 Additionally, a cohort study of 35,884 patients in 53 hospitals in South Korea revealed that lower inpatient volume per psychiatrist (high staffing) – the total length of stay for mental disorders divided by the number of psychiatrists in a hospital – was associated with a lower 30-day readmission rate (odds for readmission in high-staffing vs low-staffing hospitals: 0.38).…”

Hat die Zahl der in einer Arztpraxis behandelten Demenzpatienten Einfluss auf die Kontinuität der Behandlung mit Antidementiva?

“…Studien aus dem psychiatrischen und psychotherapeutischen Bereich weisen heterogene Ergebnisse auf [17,31]. So wurde im asiatischen Raum belegt, dass eine höhere Zahl stationär behandelter Patienten mit einer niedrigen Verweildauer assoziiert war, aber nicht mit der Reduzierung der Wiederaufnahmeraten [32,33]. Demgegenüber zeigte eine dänische Studie [34], dass große psychiatrische Krankenhäuser eine bessere Qualität der Behandlungsprozeduren aufwiesen als kleinere psychiatrische Krankenhäuser.…”