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Trends and patterns in unplanned readmissions to ISLHD hospitals following admissions for mental diseases and disorders

Journal Article


Abstract


  • Background: Reducing early (<30 days) hospital

    readmissions is a policy priority aimed at improving

    healthcare quality. Unplanned readmissions are generally

    considered undesirable events that often indicate relapse.

    Although not necessarily a reflection of healthcare, they

    may reflect on the effectiveness of the system of mental

    healthcare as a whole.

    Objectives: To describe trends in unplanned readmissions

    to Illawarra Shoalhaven Local Health District (ISLHD)

    hospitals following mental health admissions and examine

    how these vary by service factors, specific conditions and

    patient groups.

    Methods: Retrospective longitudinal study of patients

    attending ISLHD hospitals between 2002 and 2015 whose

    major diagnostic category (MDC) was Mental Diseases

    and Disorders (MDC 19) who have at least one unplanned

    readmission within 6 months of discharge.

    Findings: We found that 27% of patients admitted

    in the MDC 19 category have at least one unplanned

    readmission within 6 months of discharge – a higher

    readmission rate than for other inpatients (20%).

    Trends in the percentage readmitted since 2002 show

    an approximately 40% decrease across all age groups

    within 30 days of discharge. An increased risk of

    unplanned readmission is associated with older age,

    Aboriginal and Torres Strait Islander peoples, speaking

    English as an additional language, no health insurance,

    low socioeconomic status, an Index admission via the

    emergency department, an emergency and with length

    of stay (short stay ⩽2 days).

    conclusions: Readmission risk prediction remains a

    poorly understood and complex endeavour. Factors such as

    medical comorbidities, basic demographic data and clinical

    variables are much better able to predict mortality than

    readmission risk. Broader social, environmental and medical

    factors such as access to care, social support, substance

    abuse and functional status contribute to readmission risk.

    Readmission risk prediction is a complex endeavour with

    many inherent limitations.

Publication Date


  • 2018

Citation


  • Pai, N., Westley-Wise, V., Lago, L., Facci, F., Zingel, R., Mullan, J. & Eagar, K. (2018). Trends and patterns in unplanned readmissions to ISLHD hospitals following admissions for mental diseases and disorders. Australian and New Zealand Journal of Psychiatry, 53 (S1), 103.

Start Page


  • 103

Volume


  • 53

Issue


  • S1

Place Of Publication


  • United Kingdom

Abstract


  • Background: Reducing early (<30 days) hospital

    readmissions is a policy priority aimed at improving

    healthcare quality. Unplanned readmissions are generally

    considered undesirable events that often indicate relapse.

    Although not necessarily a reflection of healthcare, they

    may reflect on the effectiveness of the system of mental

    healthcare as a whole.

    Objectives: To describe trends in unplanned readmissions

    to Illawarra Shoalhaven Local Health District (ISLHD)

    hospitals following mental health admissions and examine

    how these vary by service factors, specific conditions and

    patient groups.

    Methods: Retrospective longitudinal study of patients

    attending ISLHD hospitals between 2002 and 2015 whose

    major diagnostic category (MDC) was Mental Diseases

    and Disorders (MDC 19) who have at least one unplanned

    readmission within 6 months of discharge.

    Findings: We found that 27% of patients admitted

    in the MDC 19 category have at least one unplanned

    readmission within 6 months of discharge – a higher

    readmission rate than for other inpatients (20%).

    Trends in the percentage readmitted since 2002 show

    an approximately 40% decrease across all age groups

    within 30 days of discharge. An increased risk of

    unplanned readmission is associated with older age,

    Aboriginal and Torres Strait Islander peoples, speaking

    English as an additional language, no health insurance,

    low socioeconomic status, an Index admission via the

    emergency department, an emergency and with length

    of stay (short stay ⩽2 days).

    conclusions: Readmission risk prediction remains a

    poorly understood and complex endeavour. Factors such as

    medical comorbidities, basic demographic data and clinical

    variables are much better able to predict mortality than

    readmission risk. Broader social, environmental and medical

    factors such as access to care, social support, substance

    abuse and functional status contribute to readmission risk.

    Readmission risk prediction is a complex endeavour with

    many inherent limitations.

Publication Date


  • 2018

Citation


  • Pai, N., Westley-Wise, V., Lago, L., Facci, F., Zingel, R., Mullan, J. & Eagar, K. (2018). Trends and patterns in unplanned readmissions to ISLHD hospitals following admissions for mental diseases and disorders. Australian and New Zealand Journal of Psychiatry, 53 (S1), 103.

Start Page


  • 103

Volume


  • 53

Issue


  • S1

Place Of Publication


  • United Kingdom