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Am J Psychiatry 1996; 153:397-403
Copyright © 1996 by American Psychiatric Association
Four-year follow-up of the influence of psychological comorbidity on medical rehospitalization
SM Saravay, S Pollack, MD Steinberg, B Weinschel and M Habert
Long Island Jewish Medical Center, Albert Einstein College of Medicine, New Hyde Park, NY 11040, USA.
OBJECTIVE: This study tested the hypothesis that psychiatric comorbidity
measured in medical and surgical general hospital inpatients predicts
increased readmissions and days spent rehospitalized at the same hospital
up to 4 years after discharge. METHOD: A convenience sample of 273
medical/surgical inpatients aged 18 years and older were given
psychological tests during their third to fifth hospital days on medical
and surgical units from June 1, 1985, through June 30, 1986. The main
outcome measure was the number of medical/surgical readmissions and number
of days rehospitalized during a 4-year follow-up at the same institution.
RESULTS: Compared to the rest of the study group, the cognitively impaired
patients (according to the Mini-Mental State examination) averaged twice as
many rehospitalizations and three times as many days rehospitalized at 6-
month follow-up and twice as many days rehospitalized at 2-year follow- up.
Compared to the rest of the group, the patients who were depressed or who
had high interpersonal sensitivity scores at the index admission spent
twice as many days rehospitalized during the 4-year follow-up, while the
patients with high hostility scores had almost twice as many readmissions.
These results remained statistically significant after separate partialing
out of the effects of severity of functional impairment, age, cognitive
impairment, and number of admissions or days spent hospitalized before the
index admission. CONCLUSIONS: Psychiatric comorbidity, previously well
documented as contributing to increased length of stay in the general
hospital, is associated with increased hospital utilization for at least 4
years after discharge.
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