Valeria Donisi1, Federico Tedeschi2, Damiano Salazzari2, Francesco Amaddeo2. 1. Section of Psychiatry, Department of Public Health and Community Medicine, University of Verona, 37134 Verona, Italy. Electronic address: valeria.donisi@univr.it. 2. Section of Psychiatry, Department of Public Health and Community Medicine, University of Verona, 37134 Verona, Italy.
Abstract
OBJECTIVE: This study aims to describe the association between pre- and post-discharge factors and early readmission to acute psychiatric wards in a well-integrated community-based psychiatric service. METHODS: The analysis consisted of all the hospital discharge records containing a psychiatric diagnosis in 2011 from four Italian acute inpatient wards. Socio-demographic, clinical, admission and aftercare variables were investigated as possible predictors of readmission at 7, 30 and 90 days after discharge and were analyzed, controlling for dependency among same-patient observations. RESULTS: Previous psychiatric history was the most important predictor of readmissions. The socio-demographic and clinical characteristics of patients did not clearly influence readmission. Length of stay (LoS) was significant for readmission at 7 days even after controlling for other predictors and for same-patient dependence, in particular, for patients with previous admissions. Results suggest a protective role of a LoS higher than 28 days. In general, having a contact in community services did not turn out as protective from early readmission. CONCLUSIONS: This paper contributes to increase the knowledge about factors that may predict the risk of early readmission. Implications for quality assessment in psychiatry emerged: readmission seems actionable by LoS and not by community follow-up.
OBJECTIVE: This study aims to describe the association between pre- and post-discharge factors and early readmission to acute psychiatric wards in a well-integrated community-based psychiatric service. METHODS: The analysis consisted of all the hospital discharge records containing a psychiatric diagnosis in 2011 from four Italian acute inpatient wards. Socio-demographic, clinical, admission and aftercare variables were investigated as possible predictors of readmission at 7, 30 and 90 days after discharge and were analyzed, controlling for dependency among same-patient observations. RESULTS: Previous psychiatric history was the most important predictor of readmissions. The socio-demographic and clinical characteristics of patients did not clearly influence readmission. Length of stay (LoS) was significant for readmission at 7 days even after controlling for other predictors and for same-patient dependence, in particular, for patients with previous admissions. Results suggest a protective role of a LoS higher than 28 days. In general, having a contact in community services did not turn out as protective from early readmission. CONCLUSIONS: This paper contributes to increase the knowledge about factors that may predict the risk of early readmission. Implications for quality assessment in psychiatry emerged: readmission seems actionable by LoS and not by community follow-up.
Authors: M Ådnanes; L Melby; J Cresswell-Smith; H Westerlund; L Rabbi; M Z Dernovšek; L Šprah; R Sfetcu; C Straßmayr; V Donisi Journal: BMC Health Serv Res Date: 2018-07-03 Impact factor: 2.655
Authors: Khader Shameer; M Mercedes Perez-Rodriguez; Roy Bachar; Li Li; Amy Johnson; Kipp W Johnson; Benjamin S Glicksberg; Milo R Smith; Ben Readhead; Joseph Scarpa; Jebakumar Jebakaran; Patricia Kovatch; Sabina Lim; Wayne Goodman; David L Reich; Andrew Kasarskis; Nicholas P Tatonetti; Joel T Dudley Journal: BMC Med Inform Decis Mak Date: 2018-09-14 Impact factor: 2.796