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Is Readmission a Valid Indicator of the Quality of Inpatient Psychiatric Care?

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Abstract

Early return to hospital is a frequently measured outcome in mental health system performance monitoring yet its validity for evaluating quality of inpatient care is unclear. This study reviewed research conducted in the last decade on predictors of early readmission (within 30 to 90 days of discharge) to assess the association between this indicator and quality of inpatient psychiatric care. Only 13 studies met inclusion criteria. Results indicated that risk is greatest in the 30-day period immediately after discharge. There was modest support that attending to stability of clinical condition and preparing patients for discharge can protect against early readmission. A history of repeated admission increases risk, suggesting that special efforts are required to break the revolving door cycle. The authors identified a need for more standardization in measurement of client status at discharge and related care processes, more intervention studies on discharge practices, and studies of the effect of community care on early readmission.

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Correspondence to Janet Durbin PhD.

Appendices

Appendix A

Literature search results

Inclusion criteria:

  • original quantitative analysis of predictors of readmission;

  • dependant variable = early readmission, that is, readmission within 90 days of discharge;

  • assessed at least one predictor of patient status or treatment during hospitalization;

  • written in English language;

  • published between 1995 and 2006.

Exclusion criteria:

  • focused exclusively on older adults (over 65 years) and children/youth (under 18 years).

Results

Table 3

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Durbin, J., Lin, E., Layne, C. et al. Is Readmission a Valid Indicator of the Quality of Inpatient Psychiatric Care?. J Behav Health Serv Res 34, 137–150 (2007). https://doi.org/10.1007/s11414-007-9055-5

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  • DOI: https://doi.org/10.1007/s11414-007-9055-5

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