Hospitalization readmission rates in patients with schizophrenia: A nationwide analysis
Introduction Schizophrenia is a chronic severe mental disorder characterized by acute decompensation episodes that may lead to hospitalization. In Portugal a previous study found a total of 25,385 hospitalizations in an 8-year period, being one of the most burdensome serious mental disorders in Por...
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| Language: | English |
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Cambridge University Press
2023-03-01
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| Series: | European Psychiatry |
| Online Access: | https://www.cambridge.org/core/product/identifier/S0924933823003322/type/journal_article |
| _version_ | 1827754776030347264 |
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| author | M. Gonçalves Pinho J. P. Ribeiro L. Fernandes A. Freitas |
| author_facet | M. Gonçalves Pinho J. P. Ribeiro L. Fernandes A. Freitas |
| author_sort | M. Gonçalves Pinho |
| collection | DOAJ |
| description |
Introduction
Schizophrenia is a chronic severe mental disorder characterized by acute decompensation episodes that may lead to hospitalization. In Portugal a previous study found a total of 25,385 hospitalizations in an 8-year period, being one of the most burdensome serious mental disorders in Portugal.Rehospitalizations (hospitalization occurring after a previous discharge due to Schizophrenia) are one of the quality-of-care indicators of schizophrenia treatment.
Objectives
This project aims to describe and quantify hospitalization readmission rates in patients with schizophrenia in Portuguese public hospitals
Methods
A descriptive study was designed according to the RECORD guidelines, using a nationwide hospitalization administrative database that contains all hospitalizations registered in Portuguese mainland public hospitals. All episodes with discharges occurring between 2008 and 2015 with a primary diagnosis of Schizophrenia were selected according to the International Classification of Diseases version 9, Clinical Modification (ICD-9-CM) codes of diagnosis 295.xx. Readmission rates were estimated using a methodological approach developed by the authors that identified patients who have been rehospitalized in <=5; <=30; <=90 and <=365 days from a previous hospitalization episode during the study period. Individual patients were identified (crosschecking three variables: birthdate; sex and place of residence). The time between discharges was calculated using the difference between an index hospitalization and the next registered hospitalization from the same patient.
Results
A total of 14,279 patients were anonymously identified in order to calculate readmission rates per patient from a total of 25,385 hospitalization episodes. The mean hospitalization per patient ratio was 1.78. A total of 367 patients (2.6%) had a readmission in <=5 days after discharge. The readmission rate at <=30 days was 8.6% (n=1224); 14.1% (n=2013) at <= 90 days and 23.7% (n=3378) at <=365 days. Readmission rates were higher in male sex patients. Shorter periods of time between readmissions were increasingly frequent in male patients (3.1% vs. 1.6% of all male vs. all female patients in <=5days readmissions; 9.6% vs. 6.5% in <=30 days readmissions; 15.7% vs. 11.0% in <=90days readmissions and 25.3% vs. 20.4% in <=365days readmissions).
Conclusions
Rehospitalizations arise as one of the indicators of treatment failure and quality of care in patients with a diagnosis of schizophrenia. Our study is the first to measure and assess readmission rates in patients with Schizophrenia in Portuguese public hospitals at a nationwide level. Portugal presents lower 30-day readmission values when compared to other countries. The 30-day readmission rate in patients with Schizophrenia in Portuguese Public Hospitals is 8.6% and male patients have higher readmission rates when compared to female patients.
Disclosure of InterestNone Declared |
| first_indexed | 2024-03-11T07:54:12Z |
| format | Article |
| id | doaj.art-13a57a5439d1441ab15d5c51e124b622 |
| institution | Directory Open Access Journal |
| issn | 0924-9338 1778-3585 |
| language | English |
| last_indexed | 2024-03-11T07:54:12Z |
| publishDate | 2023-03-01 |
| publisher | Cambridge University Press |
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| series | European Psychiatry |
| spelling | doaj.art-13a57a5439d1441ab15d5c51e124b6222023-11-17T05:06:00ZengCambridge University PressEuropean Psychiatry0924-93381778-35852023-03-0166S128S12810.1192/j.eurpsy.2023.332Hospitalization readmission rates in patients with schizophrenia: A nationwide analysisM. Gonçalves Pinho0J. P. Ribeiro1L. Fernandes2A. Freitas3Faculty of Medicine of the University of Porto CINTESIS, PortoCentro Hospitalar do Tâmega e Sousa, Penafiel, PortugalFaculty of Medicine of the University of Porto, PortoFaculty of Medicine of the University of Porto, Porto Introduction Schizophrenia is a chronic severe mental disorder characterized by acute decompensation episodes that may lead to hospitalization. In Portugal a previous study found a total of 25,385 hospitalizations in an 8-year period, being one of the most burdensome serious mental disorders in Portugal.Rehospitalizations (hospitalization occurring after a previous discharge due to Schizophrenia) are one of the quality-of-care indicators of schizophrenia treatment. Objectives This project aims to describe and quantify hospitalization readmission rates in patients with schizophrenia in Portuguese public hospitals Methods A descriptive study was designed according to the RECORD guidelines, using a nationwide hospitalization administrative database that contains all hospitalizations registered in Portuguese mainland public hospitals. All episodes with discharges occurring between 2008 and 2015 with a primary diagnosis of Schizophrenia were selected according to the International Classification of Diseases version 9, Clinical Modification (ICD-9-CM) codes of diagnosis 295.xx. Readmission rates were estimated using a methodological approach developed by the authors that identified patients who have been rehospitalized in <=5; <=30; <=90 and <=365 days from a previous hospitalization episode during the study period. Individual patients were identified (crosschecking three variables: birthdate; sex and place of residence). The time between discharges was calculated using the difference between an index hospitalization and the next registered hospitalization from the same patient. Results A total of 14,279 patients were anonymously identified in order to calculate readmission rates per patient from a total of 25,385 hospitalization episodes. The mean hospitalization per patient ratio was 1.78. A total of 367 patients (2.6%) had a readmission in <=5 days after discharge. The readmission rate at <=30 days was 8.6% (n=1224); 14.1% (n=2013) at <= 90 days and 23.7% (n=3378) at <=365 days. Readmission rates were higher in male sex patients. Shorter periods of time between readmissions were increasingly frequent in male patients (3.1% vs. 1.6% of all male vs. all female patients in <=5days readmissions; 9.6% vs. 6.5% in <=30 days readmissions; 15.7% vs. 11.0% in <=90days readmissions and 25.3% vs. 20.4% in <=365days readmissions). Conclusions Rehospitalizations arise as one of the indicators of treatment failure and quality of care in patients with a diagnosis of schizophrenia. Our study is the first to measure and assess readmission rates in patients with Schizophrenia in Portuguese public hospitals at a nationwide level. Portugal presents lower 30-day readmission values when compared to other countries. The 30-day readmission rate in patients with Schizophrenia in Portuguese Public Hospitals is 8.6% and male patients have higher readmission rates when compared to female patients. Disclosure of InterestNone Declaredhttps://www.cambridge.org/core/product/identifier/S0924933823003322/type/journal_article |
| spellingShingle | M. Gonçalves Pinho J. P. Ribeiro L. Fernandes A. Freitas Hospitalization readmission rates in patients with schizophrenia: A nationwide analysis European Psychiatry |
| title | Hospitalization readmission rates in patients with schizophrenia: A nationwide analysis |
| title_full | Hospitalization readmission rates in patients with schizophrenia: A nationwide analysis |
| title_fullStr | Hospitalization readmission rates in patients with schizophrenia: A nationwide analysis |
| title_full_unstemmed | Hospitalization readmission rates in patients with schizophrenia: A nationwide analysis |
| title_short | Hospitalization readmission rates in patients with schizophrenia: A nationwide analysis |
| title_sort | hospitalization readmission rates in patients with schizophrenia a nationwide analysis |
| url | https://www.cambridge.org/core/product/identifier/S0924933823003322/type/journal_article |
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