Demographic and Clinical Factors Associated with Re-admission in Patients Admitted to Psychiatric Hospital and Psychiatric Ward of General Hospital in 2011: A 7-Year Follow-Up after Discharge

Abstract

Background: The present study aimed to investigate the relationship between patients’ demographic/clinical factors and readmission.
 Methods: This retrospective cohort study was conducted on all patients admitted to Iran psychiatric hospital and the Psychiatric Ward of Rasoul-e-Akram Hospital in Tehran in 2011. The study variable and post-discharge readmission status in a 7-years period until 2018 were collected by reviewing patients’ clinical charts, making telephone calls or studying patients’ records at Roozbeh Hospital. Thereafter, clinical factors such as Length of Hospital Stay (LOS), diagnosis, and medication compliance were evaluated by using statistical tests, including Meier-Kaplan survival analysis, Logrank test, and Cox regression analysis and SPSS software.
 Results: The present study was conducted on 1410 inpatients, 434 women (30.8%) and 976 men (62.9%), whose most common disorder was mood disorder. The diagnoses of the patients were recorded based on DSM-IV-TR. Among the patients readmitted, the mean time to readmission was 24.94 months. Among the demographic and clinical factors, the longer length of stay, more previous hospitalizations, inpatient physical restraint, lack of therapeutic compliance, and diagnosis of psychotic disorders has increased the odds of readmission (all p<0.01).
 Conclusion: To reduce the readmission rate among these patients, we need to use some methods to reduce readmission such as psychoeducation regarding nature of the disease, importance of medication adherence, and identifying warning signs that indicate the possibility of recurrence of the disease, especially more severe such as psychotic disorders. It is also recommended to avoid physical restraint, a factor of readmission risk, during hospitalization as much as possible.