Authors (including presenting author) :
Ng PKP(1), Ng MKR(2), Lau YC(2), Siu WYM(2), Lau KS(2), Tang CK(2), Ng HPB(1), Lo WYA(1), Poon FD(1)
Affiliation :
(1)Occupational Therapy Department, Kowloon Hospital
(2)Department of Psychiatry, Kowloon Hospital
Introduction :
Hospital readmission rate was considered as a commonly used indicator to reflect quality of care provided by hospitals (Fischer et al., 2014). Several studies identified socio-demographic and clinical factors associated with psychiatric readmission (Donisi et al., 2016; Tulloch et al., 2016; Wong, 2015). As similar local studies were rare, this study intended to explore factors associated with the likelihood of psychiatric readmission.
Objectives :
This study intended to investigate factors related to hospital readmission within 1 year after discharge from the index hospitalization.
Methodology :
This retrospective cohort study involved psychiatric patients discharged to community from Kowloon Psychiatric Observation Unit in 2016. All data of potential predictors for readmission were retrieved from the Clinical Data Analysis and Reporting System (CDARS). Data of number of readmission(s), number of day(s) of hospitalization in readmission(s) and day(s) after index discharge to first readmission within 1 year after index discharge were retrieved through CDARS. Chi square test with multiple comparison follow-up tests, cox proportional hazards model and multiple linear regression were used for data analysis.
Result & Outcome :
A total of 2298 patients were recruited. 717 patients had readmission(s) during the follow-up period. Patients in the readmission group were significantly more likely to have secondary education level, to live in hostel/institution, to be diagnosed “schizophrenia, schizotypal and delusional disorders”, to be labelled Priority follow-up (PFU) target/special care, to have violence histories, to have ≥10 years duration from onset of mental illness to index admission, to have ≥1 previous psychiatric admission(s) in past 365 days before index admission, to be discharged home and to have community psychiatric service within 365 days after index discharge. 4 factors were identified to predict higher risk of psychiatric readmission, included < 45 years old, had violence histories, had ≥10 years duration from onset of mental illness to index admission, and had ≥1 previous psychiatric admission(s) in past 365 days before index admission. Moreover, ≥2 previous psychiatric admission(s) in past 365 days before index admission, and ≥30 days of index hospitalization, were 2 factors predicting longer days of hospitalization in readmission(s).
With reference to present findings, formulating a triage system for detecting at-risk patients and providing timely and comprehensive intervention was recommended.
