Psychiatric readmissions following Soteria versus traditional inpatient care: a propensity score-matched cohort study

The Soteria model offers a community-based, recovery-oriented alternative to traditional psychiatric hospitalization, yet long-term evidence regarding its association with readmission remains limited. This study evaluated whether treatment in a Soteria home is associated with lower psychiatric readmission rates compared to traditional hospital care. A retrospective analysis was conducted using Israel Ministry of Health records for patients admitted to Soteria or traditional wards in 2018, with follow-up through May 2021 (N = 164). Outcomes included readmission proportion, frequency, time-to-first readmission, and length of stay. Analysis employed propensity score matching (PSM), logistic regression, and Cox proportional hazards modelling. Soteria patients were significantly less likely to be readmitted at 24 months (41.5%vs. 61.0%) and 30 months (45.1%vs. 63.4%). They also experienced longer times to first readmission. Moderation analyses suggested that the association between Soteria care and delayed readmission was more pronounced among younger patients (≤30 years). To address diagnostic imbalances, a stratified PSM sensitivity analysis was conducted; the reduction in readmission hazard remained statistically significant (HR=0.65, 95% CI: 0.43-1.00, p = 0.048), providing partial support for the primary time-to-readmission findings. Treatment in a Soteria home was associated with lower long-term psychiatric rehospitalization, particularly among younger individuals. While the observational design precludes causal conclusions, these findings suggest that Soteria-based residential alternatives may be associated with reduced long-term psychiatric readmission compared with traditional inpatient treatment.