Rapid versus Delayed Readmission in First-Admission Psychosis: Quality Indicators for Managed Care?
- Thomas J. CraigAffiliated withBronx Veterans Administration Medical Center
- , Shmuel FennigAffiliated withShelvata Hospital
- , Marsha Tanenberg-KarantAffiliated withDepartment of Psychiatry and Behavioral Sciences, State University of New York at Stony Brook
- , Evelyn J. BrometAffiliated withDepartment of Psychiatry and Behavioral Sciences, State University of New York at Stony Brook
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This study examined clinical correlates of rapid readmission to a psychiatric inpatient service (less than 3 months after discharge) compared to delayed readmissions (3–12 months) in first-admission patients diagnosed with schizophrenia, bipolar disorder with psychosis, and major depression with psychosis. After reviewing the clinical records and research summaries of all patients who were readmitted within 1 year of discharge, we compared the two readmission groups with respect to demographic and clinical characteristics and subsequent clinical course. Rapid readmission was significantly associated with instability of clinical condition at first discharge (especially mood symptoms) and, to a lesser degree, with failure to prescribe specific medication for affective psychosis patients. Regardless of duration of community tenure, readmission was strongly associated with medication nonprescription or discontinuation. The results suggest that managed care protocols aimed at preventing rapid readmission may require specific symptom assessment and pharmacotherapeutic intervention during the initial hospitalization. Readmission can be used as a quality indicator of both clinical processes (hospital and outpatient care) so long as duration of community tenure prior to readmission is taken into account.
- Rapid versus Delayed Readmission in First-Admission Psychosis: Quality Indicators for Managed Care?
Annals of Clinical Psychiatry
Volume 12, Issue 4 , pp 233-238
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- Kluwer Academic Publishers-Plenum Publishers
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- Author Affiliations
- 1. Bronx Veterans Administration Medical Center, Bronx, New York
- 2. Shelvata Hospital, Tel Aviv, Israel
- 3. Department of Psychiatry and Behavioral Sciences, State University of New York at Stony Brook, Stony Brook, New York