Risk Factors for Early Readmission to Acute Care for Persons With Schizophrenia Taking Antipsychotic Medications
| Autor: | Marion Becker, Timothy L. Boaz, Mirko Sikirica, Jiyoon Choi, Ross Andel, Richard A. Van Dorn |
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| Rok vydání: | 2013 |
| Předmět: |
Adult
Male medicine.medical_specialty Service use Patient Readmission Patient Admission Risk Factors Acute care Health care Cox proportional hazards regression medicine Humans Psychiatry Medicaid business.industry Length of Stay Middle Aged After discharge medicine.disease United States Psychiatry and Mental health Schizophrenia Emergency medicine Florida Female Antipsychotic Medications business Antipsychotic Agents |
| Zdroj: | Psychiatric Services. 64:1225-1229 |
| ISSN: | 1557-9700 1075-2730 |
| DOI: | 10.1176/appi.ps.003382012 |
| Popis: | OBJECTIVE The study examined risk factors for readmission to acute care among Florida Medicaid enrollees with schizophrenia treated with antipsychotics. METHODS Medicaid and service use data for 2004 to 2008 were used to identify adults with schizophrenia discharged from hospitals and crisis units who were taking antipsychotics. Data were extracted on demographic characteristics, service use before admission, psychopharmacologic treatment after discharge, and readmission to acute behavioral health care. Cox proportional hazards regression estimated readmission risk in the 30 days after discharge and in the period after 30 days for participants not readmitted in the first 30 days. RESULTS The mean±SD age of the 3,563 participants was 43.4±11.1; 61% were male, and 38% were white. Participants had 6,633 inpatient episodes; duration of hospitalization was 10.6±7.0 days. Readmission occurred for 84% of episodes, 23% within 30 days. Variables associated with an increased readmission risk in the first 30 days were shorter hospitalization (hazard ratio [HR]=1.18, 95% confidence interval [CI]=1.10-1.27, plt;.001), shorter time on medication before discharge (HR=1.19, CI=1.06-1.35, p=.003), greater prehospitalization use of acute care (HR=2.64, CI=2.29-3.05, plt;.001), serious general medical comorbidity (HR=1.21, CI=1.06-1.38, p=.005), and prior substance abuse treatment (HR=1.58, CI=1.37-1.83, plt;.001). After 30 days, hospitalization duration and time on medication were not significant risk factors. CONCLUSIONS Short hospital stays for persons with schizophrenia may be associated with risk of early readmission, possibly because the person is insufficiently stabilized. More chronic risk factors include prior acute care, general medical comorbidity, and substance abuse. |
| Databáze: | OpenAIRE |
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