Socio-demographic, Clinical and Treatment-Related Factors Associated with Psychiatric Re-hospitalization: A Retrospective Study

Abstract

Introduction: Acute psychiatric care is associated with frequent readmissions and discharges; the estimated rate of re-hospitalization is approximately 40 to 50%. The present study aimed to identify the sociodemographic, clinical, and treatment-related factors responsible for re-hospitalization.
Method: This retrospective study consisted of 343 patients who were re-hospitalized during the study period, of which 43 were excluded. The remaining 300 patients were further subdivided based on the duration between discharge from the index episode and readmission (< 1 and >1 year), and sociodemographic and clinical profiles were compared. A logistic regression model was used to perform 25 imputations including all outcome variables, predictors, and covariates.
Results: The mean age of the admitted patients was 32.33 ± 9.27 years. Patients with affective disorders had the highest re-hospitalization (36.33%), followed by substance use disorders (28.3%) and psychotic disorders (27%). Over 57% of re-hospitalizations occurred within one year. Logistic regression analyses showed that precipitating factors according to presumptive stressful life events (PSLE) scale (OR-0.578), comorbid medical disorder (OR-2.898), duration of hospital stay (OR-1.231), and non-compliance to treatment (4.114) after discharge were associated with early readmission.
Conclusion: The rate of re-hospitalization was higher within one year, as compared to other similar studies. Young, educated and married males who had a shorter duration of hospital stay had a higher amount of re-hospitalization. The majority of readmitted patients had a diagnosis of mood disorders; substance use disorder and psychosis. Also combined treatment with pharmacotherapy and modified electroconvulsive therapy resulted in a lesser risk of re-hospitalizations.