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A case-control study of factors associated with multiple psychiatric readmissions
Nirma C Silva1, Diego G Bassani, Lilian S Palazzo
1Postgraduate and Masters Program in Public Health, Lutheran University of Brazil, Canoas, Brazil.
Psychiatric Services (Washington, D.C.)
|June 3, 2009
Summary
Community psychosocial support services significantly reduce multiple psychiatric readmissions. Factors like schizophrenia and younger age at first admission increase readmission risk, while proximity to hospitals also plays a role.
Area of Science:
- Psychiatry
- Public Health
- Health Services Research
Background:
- Recurrent psychiatric admissions pose a significant challenge in mental healthcare systems.
- Understanding factors influencing multiple hospitalizations is crucial for effective intervention strategies.
Purpose of the Study:
- To investigate service-related and individual-level factors associated with multiple psychiatric admissions.
- To identify predictors of recurrent psychiatric hospitalizations in a Brazilian public mental health setting.
Main Methods:
- A concurrent case-control study involving 307 adults with three or more psychiatric admissions and 354 controls with their first inpatient readmission.
- Data analyzed using a hierarchical model to account for the recurrent nature of psychiatric admissions.
- Comparison of outcomes for patients referred to community psychosocial support versus usual outpatient care.
Main Results:
- Referral to community psychosocial support units was associated with approximately 20% lower odds of multiple readmissions compared to usual outpatient care.
- Living closer to the hospital (same city) was linked to a higher likelihood of multiple readmissions.
- Diagnoses of schizophrenia or psychotic symptoms, younger age at first admission, and a higher number of previous admissions were significant predictors of multiple readmissions.
Conclusions:
- Community psychosocial support services demonstrate a strong potential in preventing multiple psychiatric admissions.
- Further research is warranted to elucidate specific effective components of these services and their cost-effectiveness.
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