Serious mental illness, other mental health disorders, and outpatient health care as predictors of 30-day readmissions following medical hospitalization
| Autor: | Jessica A. Jonikas, Judith A. Cook, Jane K. Burke-Miller, Alberto Santos, Lisa A. Razzano, Pamela J. Steigman |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
medicine.medical_specialty Adolescent Population MEDLINE Aftercare Pharmacy Logistic regression Patient Readmission 03 medical and health sciences Young Adult 0302 clinical medicine Health care Outpatients medicine Ambulatory Care Humans 030212 general & internal medicine education Retrospective Studies education.field_of_study business.industry Mental Disorders Middle Aged Mental illness medicine.disease Mental health Patient Discharge United States 030227 psychiatry Hospitalization Psychiatry and Mental health Mental Health Emergency medicine business Medicaid Delivery of Health Care |
| Zdroj: | General hospital psychiatry. 70 |
| ISSN: | 1873-7714 |
| Popis: | Objective Prior research has not addressed whether both serious mental illness (SMI) and other mental health (OMH) disorders affect the likelihood of 30-day readmissions after medical hospitalizations, or whether post-discharge use of outpatient medical, mental health, and pharmacy services is associated with readmission likelihood. Methods Using the Truven Health Analytics MarketScan® Medicaid Multi-State Database, we studied 43,817 Medicaid beneficiaries, age 18–64, following discharge from medical hospitalizations in 2011. Logistic regression models compared all-cause, 30-day readmissions among those with SMI, OMH, and no psychiatric diagnosis, and examined associations of 30-day outpatient service use with 30-day readmissions. Results Thirty-day readmission rates were 15.9% (SMI), 13.8% (OMH), and 11.7% (no mental illness). In multivariable analysis, compared to patients without mental illness, odds of readmission were greater for those with SMI (aOR = 1.43, 95%CI:1.32–1.51) and OMH (aOR = 1.21, 95%CI:1.12–1.30), and lower among those using outpatient mental health services (aOR = 0.50, 95%CI: 0.44–0.56). Conclusion The adult Medicaid population disproportionately includes patients with SMI and OMH disorders, both of which were found to be associated with 30-day hospital readmissions. Receiving outpatient mental health services after hospital discharge may be protective against readmission following medical hospitalizations, suggesting the need for further research on these topics. |
| Databáze: | OpenAIRE |
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