Sociodemographic and clinical characteristics of patients with recurrent psychiatric readmissions in Qatar

Abstract

Objective To examine the sociodemographic and clinical characteristics of psychiatric patients with recurrent psychiatric readmissions (RPR). Methods A retrospective study was conducted at Hamad General Hospital in Qatar on psychiatric patients with recurrent readmissions from August 2018 to January 2019. Results Of 380 psychiatric patients admitted during the study period, 40 (10.5%) were readmitted within 30 days of discharge. Most of the patients who were readmitted were single, male and unemployed. Psychotic spectrum disorder was the most frequent psychiatric condition and was diagnosed in 18 (45%) patients. A total of 30% of the patients were receiving treatment with anti-psychotics, and a similar number received more than one medication. Most patients showed poor or no compliance. Only 12.5% of patients stayed in the hospital for more than 5 weeks in their last admission during the study period. Conclusions Poor compliance, male sex and single status were the most common demographic and clinical features of patients with RPR. Post-discharge psychiatric care should be tailored to meet the requirements of patients prone to RPR.

Readmission of Patients to Acute Psychiatric Hospitals: Influential Factors and Interventions to Reduce Psychiatric Readmission Rates

“…Six studies (6) [ 25 , 26 ] reported that hospitalization characterized with short periods of inpatient stay, especially for first admitted patients, were associated with higher risk of readmission [ 27 ]. The short length of stays can be helpful in reducing costs in managing patients in the early stages of mental disorders [ 26 , 27 ] when there is an effective integration between inpatient units and community-based services [ 26 ].…”

“…The short length of stays can be helpful in reducing costs in managing patients in the early stages of mental disorders [ 26 , 27 ] when there is an effective integration between inpatient units and community-based services [ 26 ]. The risk of readmission was higher in the periods immediately after discharge [ 28 ]; the further away from the discharge, the lower the risk of a new admission [ 25 ]. In a study [ 29 ] conducted and published by Tedeschi et al, 2019, the predictors for readmission were a shorter length of stay (LoS); the protective factors identified in the study were young age, involuntary admission, and the intermediate number of public healthcare staff available (28).…”

“…Twenty-one studies (21) reported that the significant predictors of early readmissions were a clinical diagnosis of depressive disorder, bipolar disorder, schizoaffective disorder [ 31 ], psychotic disorder, seasonal affective disorder (SAD) [ 32 ], and non-alcohol-related disorder [ 33 ]. The demographic features such as younger ages and unemployment [ 34 , 35 ] which are perceived to be related to the severity of the mental disorder were also identified as predictors for readmission [ 25 , 35 ]. A study by Smith et al, 2015 reported that a high rate of readmissions was significantly associated with certain conditions on the index visit, namely, alcohol or drug dependence, dementia, psychotic disorders, autism, impulse control disorders, and personality disorders [ 31 , 36 ].…”

“…In a prospective cross-sectional study conducted by Czyz et al, 2016, investigating the course of suicidal ideation and future suicide attempts, it was revealed that rehospitalization was associated with a greater risk of suicide attempts [ 55 ]. Furthermore, readmission predicted distinct changes in suicidal ideation trajectories [ 25 ] within the elevated–fast declining and chronically elevated groups, and rehospitalization predicted increases in suicidal ideation during the follow-up, with a larger magnitude for the chronic group [ 29 ]. In contrast, rehospitalization was associated with a decrease in follow-up suicidal ideation in a subclinical group [ 30 ], while rehospitalization predicted a more severe course of suicide ideation for most adolescents [ 33 ].…”

Clinical Outcomes in Routine Evaluation Measures for Patients Discharged from Acute Psychiatric Care: Four-Arm Peer and Text Messaging Support Controlled Observational Study

“…A lack of routine follow-up care provided after clients are discharged from acute care units may lead to detrimental effects, including readmission and frequent emergency visits [ 12 , 13 ]. An estimated 12–22% of discharges from mental health hospitalizations may result in subsequent emergency department (ED) visits and 5–50% in hospital readmission depending on age and mental health conditions [ 14 , 15 , 16 , 17 , 18 ]. Several factors, including prior psychiatric hospitalization, multiple comorbidities, unemployment, and psychosis, have been identified as likely primary drivers of readmission within four years after hospital discharge [ 12 , 19 ].…”