Readmission to an acute psychiatric unit within 28 days of discharge: identifying those at risk
Thomas Callaly A I , Mary Hyland A , Tom Trauer B C D , Seetal Dodd A E and Michael Berk A E F G HA Mental Health, Drugs and Alcohol Services, Swanston Centre, PO Box 281, Barwon Health, Geelong, VIC 3220, Australia.
B St. Vincent’s Hospital Mental Health Service, St. Vincent’s Hospital, Melbourne, VIC 3065, Australia.
C Department of Psychological Medicine, Monash University, Clayton, VIC 3168, Australia.
D Department of Psychiatry, University of Melbourne, Parkville, VIC 3010, Australia.
E Department of Clinical and Biomedical Sciences, Barwon Health, University of Melbourne, Geelong, VIC 3220, Australia.
F The Geelong Clinic, St. Albans Park, Geelong, VIC 3219, Australia.
G Orygen Research Centre, Parkville, VIC 3052, Australia.
H Mental Health Research Institute, Parkville, VIC 3052, Australia.
I Corresponding author. Email: thomas@barwonhealth.org.au
Australian Health Review 34(3) 282-285 https://doi.org/10.1071/AH08721
Submitted: 19 November 2008 Accepted: 10 May 2009 Published: 25 August 2010
Abstract
Objective. To examine factors that could help identify those most at risk of readmission to an acute psychiatric in-patient unit within 28 days of a discharge.
Method. A detailed file audit was conducted comparing 54 consecutive patients who had been readmitted within 28 days of discharge with 61 patients, chosen at random, who had not been readmitted during the same period.
Results. Readmission within 28-days of discharge was associated with having been admitted in the previous year (P = 0.004), receiving the Disability Support Pension (P = 0.015), not having a discharge plan sent to the patient’s GP on discharge from the index admission (P = 0.05), receiving follow-up by the mental health team within 7 days of discharge (P = 0.007) and being unemployed (P = 0.015).
Conclusions. Targeting those with previous admissions for focussed discharge planning may help organisations reduce the numbers of unnecessary early readmissions.
What is known about the topic? Readmission within 28-days of discharge is being increasingly used by service funders and organisations as an indicator of the effectiveness of community care and of the organisation’s ability to provide continuous care across programs. Previous studies, mainly conducted in the US in the mid-90s, often reach contradictory conclusions and their relevance to the Australian setting is limited.
What does this paper add? This paper uses data from an Australia mental health service. It identifies patient and service characteristics associated with rapid re-admission and provides a baseline to evaluate strategies to reduce the readmission rate.
What are the implications for practitioners? This paper highlights the importance of careful discharge planning and communication with general practitioners particularly in relation to patients who have had previous admissions.
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