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October 3, 2018Journal for Healthcare Quality47 citationsOpen Access

Predictors of 30-day Postdischarge Readmission to a Multistate National Sample of State Psychiatric Hospitals

GOGlorimar Ortiz

Structured PICO

P
Population
60,254 discharges of adults aged 18 to 64 years from 127 state-operated or state-supported psychiatric hospitals in 39 states in the United States, between January 1 and December 31, 2014. Mean age 38.0 years, 63.1% male.
O
Outcome
30-day readmission to the same psychiatric hospital after discharge

Short length of stay, specific psychiatric diagnoses, and non-private living arrangements are significant predictors of 30-day readmission to state psychiatric hospitals.

Limitations

  • Generalization could be limited for other psychiatric inpatient providers
  • Analyzed discharges, not the unique count of patients
  • Readmission period was limited to 30 days after discharge
  • Other possible predictors were not available
  • Seventeen percent of hospitals were not included because they submitted samples for the continuing care plan data
  • Analysis accounted for a small part of the variability in the outcome measure

Abstract

BACKGROUND: Early discharge from psychiatric inpatient care may pose challenges for the patient's recovery and may incite a rapid return to the hospital. This study identified demographic, clinical, and the continuing of care characteristics associated with rapid readmission into a sample of psychiatric inpatient hospitals. METHODS: Cross-sectional analysis of 60,254 discharges from state psychiatric hospitals. Logistic regression explored the relationship between predictors of rapid readmission. RESULTS: Eight percent of discharges were readmitted to the same hospital within 30 days after discharge. Factors significantly related with rapid readmission included white (odds ratio, 1.23; 95% confidence interval, 1.13-1.34), non-Hispanic (1.48, 1.26-1.73), not married (1.53, 1.32-1.76), voluntarily admitted (1.18, 1.05-1.33), with length of stay (LOS) ≤ 7 days (3.52, 3.04-4.08), or LOS 8-31 days (3.20, 2.79-3.66), or LOS 32-92 days (1.91, 1.65-2.22), with a schizophrenia or other psychotic disorders (1.69, 1.46-1.96) or personality disorder (1.76, 1.50-2.06), referred to a setting different from the outpatient (1.27, 1.16-1.40), or with a living arrangement different from private residence (1.54, 1.40-1.68). CONCLUSIONS: Disparities in rapid readmission rates exist among state psychiatric hospitals. A national overview of the individuals with mental illness at risk of being prematurely discharged may suggests insights into quality initiatives aimed at reducing rapid readmissions into psychiatric inpatient care.

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Cite This Study

Glorimar Ortiz (2018) studied this question.

synapsesocial.com/papers/6a81e8359048143b53776c75https://doi.org/10.1097/jhq.0000000000000162
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