Effectiveness of Interventions After Psychiatric Hospitalization: A Meta-Analysis of Randomized Controlled Trials

Reducing psychiatric readmission rate is an important goal because psychiatric hospitalization ranks among the highest hospitalization rates. Although individual posthospitalization interventions can reduce psychiatric readmissions, the effectiveness of these interventions remains inconclusive. The authors evaluated the effectiveness of posthospitalization interventions in reducing psychiatric readmissions and improving psychiatric outcomes.

Ovid MEDLINE, Web of Science, Scopus, and CINAHL databases were searched for articles published between January 2000 and December 2024. Randomized controlled trials (RCTs) examining interventions after psychiatric hospitalization were identified. Data screening and extraction were conducted by at least two reviewers. A random-effects meta-analysis was conducted, as well as multiple stratified subgroup analyses, and pooled relative risks were estimated.

Twelve RCT studies with 3,663 participants were included, of which only two (17%) had a high risk of bias and were accounted for in the sensitivity analysis. Posthospitalization intervention categories were case management, care coordination, care plan, and peer support. Compared with standard care, the effect of posthospitalization interventions on psychiatric readmissions yielded a pooled risk ratio of 0.96 (95% CI=0.86-1.08, p=0.52), suggesting no evidence of a statistically significant reduction in readmission rates. However, after subgroup analyses, effectiveness was found to be associated with length of intervention. Improvement in psychiatric outcomes varied, and no common improvement was found among studies.

A one-size-fits-all approach may not be effective in reducing psychiatric readmissions, supporting more targeted approaches and posthospitalization interventions that consider patient-specific profiles and needs, engagement in treatment, and availability of services. This study provides meaningful information to fill the knowledge gap on the effectiveness of posthospitalization interventions in reducing psychiatric readmissions.