Independent Predictors of 30-Day Readmission to Acute Psychiatric Wards in Patients With Mental Disorders: A Systematic Review and Meta-Analysis

Overview

Journal Cureus

Specialty Biomedical Engineering

Date 2023 Aug 28

PMID 37637588

Authors

Nazar Muhammad

Saifullah Talpur

Niraj Sangroula

Fnu Washdave

Affiliations

Soon will be listed here.

Abstract

Psychiatric readmissions have long been considered significant indicators for healthcare planning. The aim of this study was to identify factors influencing early (30-day) readmissions to acute psychiatric wards. A meta-analysis and systematic review were conducted according to Meta-analysis of Observational Studies in Epidemiology (MOOSE) guidelines. Comprehensive database searching was conducted using online databases, including PubMed and Google Scholar, to search for articles identifying factors associated with early (30-day) readmissions to acute psychiatric wards. Keywords used to search for relevant articles included "Mental illness," "readmission," and factors along with their synonyms and Medical Subject Headings (MeSH) terms. The search included studies published between 2011 and June 2023. A total of 13 studies were included in this meta-analysis. The pooled rate of the 30-day readmission was 16% (95% confidence interval: 13%-20%). A pooled analysis showed that factors significantly associated with an unplanned hospital readmission included gender, length of stay, and insurance status as predictors of the unplanned hospital readmission among individuals with psychiatric illness. Additionally, we also found that the rate of 30-day unplanned admissions was greater in patients with schizophrenia, followed by personality disorder, bipolar disorder, depression, and substance use. This study highlights the importance of providing targeted interventions and support for individuals with these conditions to reduce the risk of readmissions.

Citing Articles

Factors Associated with Hospital Readmission in a Population with a Diagnosis of Personality Disorder.

Carbonel-Aranda V, Gonzalez A, Garcia-Illanes Y, Traverso-Rodriguez M, Bordallo-Aragon A, Goodman-Casanova J Actas Esp Psiquiatr. 2024; 52(6):750-758.

PMID: 39665603 PMC: 11636539. DOI: 10.62641/aep.v52i6.1796.

Factors Associated with Readmission within 30 Days of Hospital Discharge of Psychiatric Patients: Case-Control Study.

Cabello-Rangel H, Estrada-Martinez M, Martinez-Torres M Actas Esp Psiquiatr. 2024; 52(4):405-411.

PMID: 39129692 PMC: 11319751. DOI: 10.62641/aep.v52i4.1651.

References

Chen J, Novak P, Barath D, Goldman H, Mortensen K . Local Health Departments' Promotion of Mental Health Care and Reductions in 30-Day All-Cause Readmission Rates in Maryland. Med Care. 2017; 56(2):153-161. DOI: 10.1097/MLR.0000000000000850. View

Heeren O, Dixon L, Gavirneni S, Regenold W . The association between decreasing length of stay and readmission rate on a psychogeriatric unit. Psychiatr Serv. 2002; 53(1):76-9. DOI: 10.1176/appi.ps.53.1.76. View

Boaz T, Becker M, Andel R, Van Dorn R, Choi J, Sikirica M . Risk factors for early readmission to acute care for persons with schizophrenia taking antipsychotic medications. Psychiatr Serv. 2013; 64(12):1225-9. DOI: 10.1176/appi.ps.003382012. View

Zhu T, Jiang J, Hu Y, Zhang W . Individualized prediction of psychiatric readmissions for patients with major depressive disorder: a 10-year retrospective cohort study. Transl Psychiatry. 2022; 12(1):170. PMC: 9035153. DOI: 10.1038/s41398-022-01937-7. View

Han X, Jiang F, Tang Y, Needleman J, Guo M, Chen Y . Factors associated with 30-day and 1-year readmission among psychiatric inpatients in Beijing China: a retrospective, medical record-based analysis. BMC Psychiatry. 2020; 20(1):113. PMC: 7065326. DOI: 10.1186/s12888-020-02515-1. View

Tyler N, Wright N, Waring J . Interventions to improve discharge from acute adult mental health inpatient care to the community: systematic review and narrative synthesis. BMC Health Serv Res. 2019; 19(1):883. PMC: 6876082. DOI: 10.1186/s12913-019-4658-0. View

Cook J, Burke-Miller J, Jonikas J, Aranda F, Santos A . Factors associated with 30-day readmissions following medical hospitalizations among Medicaid beneficiaries with schizophrenia, bipolar disorder, and major depressive disorder. Psychiatry Res. 2020; 291:113168. DOI: 10.1016/j.psychres.2020.113168. View

Pottick K, McAlpine D, Andelman R . Changing patterns of psychiatric inpatient care for children and adolescents in general hospitals, 1988-1995. Am J Psychiatry. 2000; 157(8):1267-73. DOI: 10.1176/appi.ajp.157.8.1267. View

Krishnan K . Psychiatric and medical comorbidities of bipolar disorder. Psychosom Med. 2005; 67(1):1-8. DOI: 10.1097/01.psy.0000151489.36347.18. View

10.

Del Favero E, Montemagni C, Villari V, Rocca P . Factors associated with 30-days and 180-days psychiatric readmissions: A snapshot of a metropolitan area. Psychiatry Res. 2020; 292:113309. DOI: 10.1016/j.psychres.2020.113309. View

11.

Appleby L, Desai P, Luchins D, Gibbons R, Hedeker D . Length of stay and recidivism in schizophrenia: a study of public psychiatric hospital patients. Am J Psychiatry. 1993; 150(1):72-6. DOI: 10.1176/ajp.150.1.72. View

12.

Kessler R, Nelson C, McGonagle K, Liu J, Swartz M, Blazer D . Comorbidity of DSM-III-R major depressive disorder in the general population: results from the US National Comorbidity Survey. Br J Psychiatry Suppl. 1996; (30):17-30. View

13.

Everett J, Druyor K, Krasinski C, Obaid M, Li Y . Predictors of behavioral health unit readmission within 30 days of discharge: A retrospective study. Heliyon. 2022; 8(10):e10784. PMC: 9547231. DOI: 10.1016/j.heliyon.2022.e10784. View

14.

Ortiz G . Predictors of 30-day Postdischarge Readmission to a Multistate National Sample of State Psychiatric Hospitals. J Healthc Qual. 2018; 41(4):228-236. PMC: 6716555. DOI: 10.1097/JHQ.0000000000000162. View

15.

Viggiano T, Pincus H, Crystal S . Care transition interventions in mental health. Curr Opin Psychiatry. 2012; 25(6):551-8. DOI: 10.1097/YCO.0b013e328358df75. View

16.

Innes H, Lewsey J, Smith D . Predictors of admission and readmission to hospital for major depression: A community cohort study of 52,990 individuals. J Affect Disord. 2015; 183:10-4. DOI: 10.1016/j.jad.2015.04.019. View

17.

Pridmore S, Hornsby H, Hay D, Jones I . Survival analysis and readmission in mood disorder. Br J Psychiatry. 1994; 165(6):824-7. DOI: 10.1192/bjp.165.6.824. View

18.

Monnelly E . Instability before discharge and previous psychiatric admissions as predictors of early readmission. Psychiatr Serv. 1997; 48(12):1584-6. DOI: 10.1176/ps.48.12.1584. View

19.

Hariman K, Cheng K, Lam J, Leung S, Lui S . Clinical risk model to predict 28-day unplanned readmission via the accident and emergency department after discharge from acute psychiatric units for patients with psychotic spectrum disorders. BJPsych Open. 2020; 6(1):e13. PMC: 7001467. DOI: 10.1192/bjo.2019.97. View

20.

Olfson M, Mechanic D, Boyer C, Hansell S, Walkup J, Weiden P . Assessing clinical predictions of early rehospitalization in schizophrenia. J Nerv Ment Dis. 2000; 187(12):721-9. DOI: 10.1097/00005053-199912000-00003. View