Predictors for early and long-term readmission in involuntarily admitted patients
Background: It is a common aim to reduce psychiatric readmissions. Although risk factors for readmissions were described, specific data in the group of patients with potentially aversively experienced involuntary admissions are lacking. To better understand underlying mechanisms, it is important to...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2024-01-01
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| Series: | Comprehensive Psychiatry |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S0010440X23000767 |
| _version_ | 1797398701888503808 |
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| author | Mario Müller Nathalie Brackmann Philipp Homan Stefan Vetter Erich Seifritz Vladeta Ajdacic-Gross Florian Hotzy |
| author_facet | Mario Müller Nathalie Brackmann Philipp Homan Stefan Vetter Erich Seifritz Vladeta Ajdacic-Gross Florian Hotzy |
| author_sort | Mario Müller |
| collection | DOAJ |
| description | Background: It is a common aim to reduce psychiatric readmissions. Although risk factors for readmissions were described, specific data in the group of patients with potentially aversively experienced involuntary admissions are lacking. To better understand underlying mechanisms, it is important to identify factors that are linked to readmissions in this specific patient group, which is the purpose of the current paper. Methods: A four-year cohort of N = 3575 involuntary admissions (IA) was followed-up for subsequent re-hospitalization. Demographic, administrative and clinical factors associated with short- (within 30 days) or long-term (> 30 days) readmissions were examined using logistic regression modelling. Results: Almost half of all IA cases were readmitted within the observation period, whereof every fifth readmission was within the first month after discharge from the involuntary index hospitalization. Adjusted regression modelling revealed problematic substance use at admission and assisted living or homelessness as risk factors for readmission, while high functioning at discharge, anxiety disorders, no subsequent treatment after discharge or IA due to danger to others were negatively associated with readmission. Factors specifically linked to short-term readmission were substance use and personality disorders, abscondence or discharge by initiation of the clinic, as well as being discharged to any place except the patient's home. There were no specific risk-factors for long-term readmission. Conclusions: To prevent readmissions after IA, especially for patients at risk, the aim of treatment strategies should be to focus on intensive discharge planning, enable continuous treatment in the outpatient setting, and provide social support. |
| first_indexed | 2024-03-09T01:29:17Z |
| format | Article |
| id | doaj.art-56e688e19b0a43f196d55e8c8e591168 |
| institution | Directory Open Access Journal |
| issn | 0010-440X |
| language | English |
| last_indexed | 2024-03-09T01:29:17Z |
| publishDate | 2024-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Comprehensive Psychiatry |
| spelling | doaj.art-56e688e19b0a43f196d55e8c8e5911682023-12-10T06:13:36ZengElsevierComprehensive Psychiatry0010-440X2024-01-01128152439Predictors for early and long-term readmission in involuntarily admitted patientsMario Müller0Nathalie Brackmann1Philipp Homan2Stefan Vetter3Erich Seifritz4Vladeta Ajdacic-Gross5Florian Hotzy6Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Lenggstrasse 31, 8032 Zürich, Switzerland; Corresponding author.Department of Forensic Psychiatry, Psychiatric University Hospital Zurich, University of Zurich, Lenggstrasse 31, 8032 Zürich, SwitzerlandDepartment of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Lenggstrasse 31, 8032 Zürich, SwitzerlandDepartment of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Lenggstrasse 31, 8032 Zürich, SwitzerlandDepartment of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Lenggstrasse 31, 8032 Zürich, SwitzerlandDepartment of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Lenggstrasse 31, 8032 Zürich, SwitzerlandDepartment of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Lenggstrasse 31, 8032 Zürich, SwitzerlandBackground: It is a common aim to reduce psychiatric readmissions. Although risk factors for readmissions were described, specific data in the group of patients with potentially aversively experienced involuntary admissions are lacking. To better understand underlying mechanisms, it is important to identify factors that are linked to readmissions in this specific patient group, which is the purpose of the current paper. Methods: A four-year cohort of N = 3575 involuntary admissions (IA) was followed-up for subsequent re-hospitalization. Demographic, administrative and clinical factors associated with short- (within 30 days) or long-term (> 30 days) readmissions were examined using logistic regression modelling. Results: Almost half of all IA cases were readmitted within the observation period, whereof every fifth readmission was within the first month after discharge from the involuntary index hospitalization. Adjusted regression modelling revealed problematic substance use at admission and assisted living or homelessness as risk factors for readmission, while high functioning at discharge, anxiety disorders, no subsequent treatment after discharge or IA due to danger to others were negatively associated with readmission. Factors specifically linked to short-term readmission were substance use and personality disorders, abscondence or discharge by initiation of the clinic, as well as being discharged to any place except the patient's home. There were no specific risk-factors for long-term readmission. Conclusions: To prevent readmissions after IA, especially for patients at risk, the aim of treatment strategies should be to focus on intensive discharge planning, enable continuous treatment in the outpatient setting, and provide social support.http://www.sciencedirect.com/science/article/pii/S0010440X23000767Involuntary admissionShort-term readmissionRevolving-doorCoercionRecovery |
| spellingShingle | Mario Müller Nathalie Brackmann Philipp Homan Stefan Vetter Erich Seifritz Vladeta Ajdacic-Gross Florian Hotzy Predictors for early and long-term readmission in involuntarily admitted patients Comprehensive Psychiatry Involuntary admission Short-term readmission Revolving-door Coercion Recovery |
| title | Predictors for early and long-term readmission in involuntarily admitted patients |
| title_full | Predictors for early and long-term readmission in involuntarily admitted patients |
| title_fullStr | Predictors for early and long-term readmission in involuntarily admitted patients |
| title_full_unstemmed | Predictors for early and long-term readmission in involuntarily admitted patients |
| title_short | Predictors for early and long-term readmission in involuntarily admitted patients |
| title_sort | predictors for early and long term readmission in involuntarily admitted patients |
| topic | Involuntary admission Short-term readmission Revolving-door Coercion Recovery |
| url | http://www.sciencedirect.com/science/article/pii/S0010440X23000767 |
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