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Am J Psychiatry 1997; 154:337-340
Copyright © 1997 by American Psychiatric Association
Predicting readmission to the psychiatric hospital in a managed care environment: implications for quality indicators
JS Lyons, MT O'Mahoney, SI Miller, J Neme, J Kabat and F Miller
Department of Psychiatry and Behavioral Sciences, Northwestern University Medical School, Chicago, IL 60611-3008, USA.
OBJECTIVE: This study examined predictors of hospital readmission to
determine whether readmissions can serve as a quality indicator for an
inpatient psychiatric service. METHOD: A series of 255 patients
consecutively admitted to any of seven psychiatric hospitals in a regional
managed care program were followed to determine whether they were
readmitted within 6 months of discharge. Case managers assessed patients
with the use of a reliable outcome management/decision support system
designed for acute psychiatric services. RESULTS: Patients with greater
impairment in self-care, more severe symptoms, and more persistent
illnesses were more likely to be readmitted than other patients. Suicidal
patients were less likely to be readmitted. There was no evidence to
suggest that poor hospital outcome or premature discharge was associated
with readmission either within 30 days or within 6 months. CONCLUSIONS:
Although patients at risk for hospital admission can be identified, it does
not appear that the success of the hospital intervention per se influences
the likelihood of readmission. Use of readmission rates as quality
indicators for hospital care providers is not recommended.
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