Sociodemographic, clinical and pharmacological factors influencing early readmission in mental health settings

Abstract

Background. Early readmissions (between 24 hours and 30 days after discharge) can be disruptive for psychiatric patients and their families. The aim of this study is to determine the factors influencing this early readmission.

Methods. A retrospective case-control study was carried out from 2015 to 2017. Cases were matched with controls with a similar age (± 10 years), admission date (± 30 days), ICD-10 diagnosis and sex. Sociodemographic, clinical and pharmacological factors were examined.

Results. 86 cases and 86 controls were chosen. The largest ICD-10 group was F20-29 (70,9%). Statistically significant (SS) factors according to the bivariate analysis were: urban vs. rural living environment (p=0.011); poor subjective pharmacological adherence (AdFa, p=0.048); poor objective AdFa (p=0.023); poor social or family support (p=0.019); poor follow-up in psychiatric outpatient consultations (p=0.021); unemployment (p=0.046); and a higher number of readmissions during the previous year (p<0.001). In the multivariate analysis, SS factors were: urban living environment (OR=2.791; 95% CI, 1.017–7.663; p=0.046); poor social or family support (OR=2.255; 95% CI, 1.160– 4.384; p=0.017); poor follow-up in psychiatric outpatient consultations (OR=2.156; 95% CI, 1.101–4.223; p=0.025); and a higher number of readmissions during the previous year (OR=1.536; 95% CI, 1.174–2.009; p=0.002).

Conclusions. Living in an urban environment; poor AdFa; poor social or family support; poor follow-up in psychiatric outpatient consultations; unemployment; and a higher number of readmissions during the previous year were all directly related to early readmissions for psychiatric patients.