Reducing hospital readmission in depression and schizophrenia: current evidence

Abstract

Purpose of review It is estimated that the readmission rate for discharged psychiatric patients is approximately 40-50% within 1 year of hospital discharge. This review focuses on recent developments in our understanding of predictors of readmission in depression and schizophrenia, and on quality improvement methods and models aimed at reducing readmission rates for these patients. Recent findings Multiple factors contribute to the risk of hospital readmission; however, demographic and clinical characteristics alone are of limited utility in identifying patients most likely to be readmitted. Recent research has emphasized the role of enhancing treatment and medication adherence, which is of critical importance given the strong association between non-adherence and rehospitalization. Methodological work is currently underway to improve the measurement of medication adherence and continuity of care, which have been difficult to assess in the past. Despite significant progress during the past few years, the development and evaluation of structured disease management programs for depression and bipolar disorder continues to represent an important challenge for future research. Summary Empirical work is needed to evaluate the effectiveness of different approaches to reducing patient readmission following hospital discharge.