Overview of post-discharge predictors for psychiatric re-hospitalisations: a systematic review of the literature

BMC Psychiatry

Research Article

H. Katschnig¹  K. Wahlbeck²  P. Haaramo²  S. Musat³  M. Ciutan³  G. Scintee³  R. Sfetcu⁴  C. Vladescu⁵ 

[1] IMEHPS, Vienna, Austria;National Institute for Health and Welfare, Mental Health Unit, Helsinki, Finland;National School of Public Health, Management and Professional Development, Bucharest, Romania;National School of Public Health, Management and Professional Development, Bucharest, Romania;Psychology Department, Spiru Haret University, Bucharest, Romania;National School of Public Health, Management and Professional Development, Bucharest, Romania;Victor Babes University of Medicine and Pharmacy, Timisoara, Romania;

关键词: Readmission;    Post-discharge factors;    Aftercare;    Community care;    System responsiveness;    Social support;    Contextual factors;    Systematic review;   

DOI  :  10.1186/s12888-017-1386-z

 received in 2016-06-14, accepted in 2017-06-12,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundHigh levels of hospital readmission (rehospitalisation rates) is widely used as indicator of a poor quality of care. This is sometimes also referred to as recidivism or heavy utilization. Previous studies have examined a number of factors likely to influence readmission, although a systematic review of research on post-discharge factors and readmissions has not been conducted so far. The main objective of this review was to identify frequently reported post-discharge factors and their effects on readmission rates.MethodsStudies on the association between post-discharge variables and readmission after an index discharge with a main psychiatric diagnosis were searched in the bibliographic databases Ovid Medline, PsycINFO, ProQuest Health Management, OpenGrey and Google Scholar. Relevant articles published between January 1990 and June 2014 were included. A systematic approach was used to extract and organize in categories the information about post-discharge factors associated with readmission rates.ResultsOf the 760 articles identified by the initial search, 80 were selected for this review which included a total number of 59 different predictors of psychiatric readmission. Subsequently these were grouped into four categories: 1) individual vulnerability factors, 2) aftercare related factors, 3) community care and service responsiveness, and 4) contextual factors and social support. Individual factors were addressed in 58 papers and were found to be significant in 37 of these, aftercare factors were significant in 30 out of the 45 papers, community care and social support factors were significant in 21 out of 31 papers addressing these while contextual factors and social support were significant in all seven papers which studied them.ConclusionsThis review represents a first attempt at providing an overview of post-discharge factors previously studied in association with readmission. Hence, by mapping out the current research in the area, it highlights the gaps in research and it provides guidance future studies in the area.

【 授权许可】

CC BY   
© The Author(s). 2017