What leads to frequent re-hospitalisation when community care is not well developed?

Abstract

Background: Treatment programmes are largely hospital based in developing countries and yet research on factors predicting frequent re-hospitalisation remains scarce from them. This cross-sectional study of factors predictive of frequent re-hospitalisation explored whether factors reported from developed countries could apply to India. Methods: Information was collected on four dimensions (socio-demographic, socio-cultural, treatment and illness variables) from 90 patients readmitted to a teaching psychiatric institute in India over a 3 month period. Patients were grouped into Frequently Re-hospitalised (FR) with three or more admissions to hospital in the last 18 months and Less Frequently Re-hospitalised (LFR) with two or fewer admissions in the last 18 months. Results: Support available for treatment, days spent in hospital and cost of treatment had a significant effect on whether the patient was more frequently hospitalised. The place of domicile tended to have an effect on the frequency of hospitalisation. Conclusions: Factors predictive of frequent re-hospitalisation reported in this study differed from those in developed countries. The above variables identify high users of inpatient beds who may be targeted for specific interventions to reduce re-hospitalisation rates.