Skip to main content
SpringerLink
Log in

Risk Factors for Inpatient Psychiatric Readmission: Are There Gender Differences?

  • Original Paper
  • Published:
Community Mental Health Journal Aims and scope Submit manuscript

Abstract

The objectives of the study were to compare characteristics of women and men discharged from an inpatient psychiatric facility and to identify gender-specific risk factors associated with 30-day and 1-year readmission using administrative data. The sample included adults discharged from an inpatient psychiatric facility in a Midwestern city (N = 1853). The analysis showed that the 30-day readmission rate was significantly lower among women, but there was no difference in the 1-year readmission rate. Risk factors for readmission differed by gender. For example, for 30-day readmission, being on Medicare versus commercial insurance increased the odds for women (OR 3.08; 95 % CI 1.35–7.04) and taking first-generation antipsychotics versus no antipsychotics increased the odds for men (OR 2.09; 95 % CI 1.26–3.48). These findings suggest there are important differences between women and men readmitted to an inpatient psychiatric facility. Future strategies need to take into account gender-specific risk factors in order to improve long-term patient outcomes.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Afifi, M. (2007). Gender differences in mental health. Singapore Medical Journal, 48(5), 385.

    CAS  PubMed  Google Scholar 

  • Andersen, R. M. (1995). Revisiting the behavioural model and access to medical care: Does it matter? Journal of Health and Social Behavior, 36, 1–10.

    Article  CAS  PubMed  Google Scholar 

  • Bernardo, A. C., & Forchuk, C. (2001). Factors associated with readmission to a psychiatric facility. Psychiatric Services, 52(8), 1100–1102.

    Article  CAS  PubMed  Google Scholar 

  • Bramness, J. G., Walby, F. A., Hjellvik, V., Selmer, R., & Tverdal, A. (2010). Self-reported mental health and its gender differences as a predictor of suicide in the middle-aged. American Journal of Epidemiology, 172(2), 160–166.

    Article  PubMed  Google Scholar 

  • Bridge, J. A., & Barbe, R. P. (2004). Reducing hospital readmission in depression and schizophrenia: Current evidence. Current Opinion in Psychiatry, 17(6), 505–511.

    Article  Google Scholar 

  • Chan, M. F., Wong, F. K. Y., Chang, K. K. P., Chow, S. K. Y., Chung, L. Y. F., Lee, R. P. L., & Lee, W. M. (2008). A study on investigating unplanned readmission patterns. Journal of Clinical Nursing, 17(16), 2164–2173.

    Article  PubMed  Google Scholar 

  • Frese, F. J., Knight, E. L., & Saks, E. (2009). Recovery from schizophrenia: With views of psychiatrists, psychologists, and others diagnosed with this disorder. Schizophrenia Bulletin, 35(2), 370–380.

    Article  PubMed  PubMed Central  Google Scholar 

  • Grant, B. F., Dawson, D. A., Stinson, F. S., Chou, S. P., Dufour, M. C., & Pickering, R. P. (2004). The 12-month prevalence and trends in DSM-IV alcohol abuse and dependence: United States, 1991–1992 and 2001–2002. Drug and Alcohol Dependence, 74(3), 223–234.

    Article  PubMed  Google Scholar 

  • Hendryx, M. S., Russo, J. E., Stegner, B., Dyck, D. G., Ries, R. K., & Roy-Byrne, P. (2003). Predicting rehospitalization and outpatient services from administration and clinical databases. The Journal of Behavioral Health Services & Research, 30(3), 342–351.

    Article  Google Scholar 

  • Howell, S., Silberberg, M., Quinn, W. V., & Lucas, J. A. (2007). Determinants of remaining in the community after discharge: Results from New Jersey’s nursing home transition program. The Gerontologist, 47(4), 535–547.

    Article  PubMed  Google Scholar 

  • Junghan, U. M., & Brenner, H. D. (2006). Heavy use of acute in-patient psychiatric services: The challenge to translate a utilization pattern into service provision. Acta Psychiatrica Scandinavica, 113(s429), 24–32.

    Article  Google Scholar 

  • Kaiser Family Foundation (2015). State health facts: Medicaid enrollment by gender. http://kff.org/medicaid/state-indicator/medicaid-enrollment-by-gender/

  • Kolbasovsky, A., Reich, L., & Futterman, R. (2007). Predicting future hospital utilization for mental health conditions. The Journal of Behavioral Health Services & Research, 34(1), 34–42.

    Article  Google Scholar 

  • Korkeila, J. A., Lehtinen, V., Tuori, T., & Helenius, H. (1998). Frequently hospitalised psychiatric patients: A study of predictive factors. Social Psychiatry and Psychiatric Epidemiology, 33(11), 528–534.

    Article  CAS  PubMed  Google Scholar 

  • Lien, L. (2002). Are readmission rates influenced by how psychiatric services are organized? Nordic Journal of Psychiatry, 56(1), 23–28.

    Article  PubMed  Google Scholar 

  • Lin, C. H., Chen, Y. S., Lin, C. H., & Lin, K. S. (2007). Factors affecting time to rehospitalization for patients with major depressive disorder. Psychiatry and Clinical Neurosciences, 61(3), 249–254.

    Article  PubMed  Google Scholar 

  • Madi, N., Zhao, H., Li, J. (2007). Hospital readmissions for patients with mental illness in Canada. Healthcare Quarterly, 10(2), 30–32.

    Article  PubMed  Google Scholar 

  • Mark, T. L., & Buck, J. A. (2005). Datapoints: Components of spending for medicaid mental health services, 2001. Psychiatric Services, 56(6), 648.

    Article  PubMed  Google Scholar 

  • Matheson, F. I., Smith, K. L., Moineddin, R., Dunn, J. R., & Glazier, R. H. (2014). Mental health status and gender as risk factors for onset of physical illness over 10 years. Journal of Epidemiology and Community Health, 68(1), 64–70.

    Article  PubMed  Google Scholar 

  • McLean, C. P., Asnaani, A., Litz, B. T., & Hofmann, S. G. (2011). Gender differences in anxiety disorders: prevalence, course of illness, comorbidity and burden of illness. Journal of Psychiatric Research, 45(8), 1027–1035.

    Article  PubMed  PubMed Central  Google Scholar 

  • Monnelly, E. P. (1997). Instability before discharge and previous psychiatric admissions as predictors of early readmission. Psychiatric Services, 48(12), 1584–1586.

    Article  CAS  PubMed  Google Scholar 

  • Morlino, M., Calento, A., Schiavone, V., Santone, G., Picardi, A., & de Girolamo, G. (2011). Use of psychiatric inpatient services by heavy users: findings from a national survey in Italy. European Psychiatry, 26(4), 252–259.

    Article  CAS  PubMed  Google Scholar 

  • Moss, J., Li, A., Tobin, J., Weinstein, I. S., Harimoto, T., & Lanctôt, K. L. (2014). Predictors of readmission to a psychiatry inpatient unit. Comprehensive Psychiatry, 55(3), 426–430.

    Article  PubMed  Google Scholar 

  • National Alliance on Mental Illness. (2014). Policymakers toolkit: Commonly prescribed psychotropic medications. Accessed July 13, 2014. http://www2.nami.org/Template.cfm?Section=Policymakers_Toolkit&Template=/ContentManagement/HTMLDisplay.cfm&ContentID=18971

  • Nelson, E. A., Maruish, M. E., & Axler, J. L. (2000). Effects of discharge planning and compliance with outpatient appointments on readmission rates. Psychiatric Services, 51(7), 885–889.

    Article  CAS  PubMed  Google Scholar 

  • Olfson, M., Mechanic, D., Boyer, C. A., Hansell, S., Walkup, J., & Weiden, P. J. (1999). Assessing clinical predictions of early rehospitalization in schizophrenia. The Journal of Nervous and Mental Disease, 187(12), 721–729.

    Article  CAS  PubMed  Google Scholar 

  • Price, L. M. (2007). Transition to community: a program to help clients with schizophrenia move from inpatient to community care; a pilot study. Archives of Psychiatric Nursing, 21(6), 336–344.

    Article  PubMed  Google Scholar 

  • Prince, J. D., Akincigil, A., Hoover, D. R., Walkup, J. T., Bilder, S., & Crystal, S. (2009). Substance abuse and hospitalization for mood disorder among Medicaid beneficiaries. American Journal of Public Health, 99(1), 160.

    Article  PubMed  PubMed Central  Google Scholar 

  • Raven, M. C., Billings, J. C., Goldfrank, L. R., Manheimer, E. D., & Gourevitch, M. N. (2009). Medicaid patients at high risk for frequent hospital admission: Real-time identification and remediable risks. Journal of Urban Health, 86(2), 230–241.

    Article  PubMed  Google Scholar 

  • Read, S., & Grundy, E. (2011). Mental health among older married couples: The role of gender and family life. Social Psychiatry and Psychiatric Epidemiology, 46(4), 331–341.

    Article  PubMed  Google Scholar 

  • Roick, C., Gärtner, A., Heider, D., Dietrich, S., & Angermeyer, M. C. (2006). Heavy use of psychiatric inpatient care from the perspective of the patients affected. International Journal of Social Psychiatry, 52(5), 432–446.

    Article  PubMed  Google Scholar 

  • Schmutte, T., Dunn, C. L., & Sledge, W. H. (2010). Predicting time to readmission in patients with recent histories of recurrent psychiatric hospitalization: A matched-control survival analysis. The Journal of Nervous and Mental Disease, 198(12), 860–863.

    Article  PubMed  Google Scholar 

  • Thompson, E. E., Neighbors, H. W., Munday, C., & Trierweiler, S. (2003). Length of stay, referral to aftercare, and rehospitalization among psychiatric inpatients. Psychiatric Services, 54(9), 1271–1276.

    Article  PubMed  Google Scholar 

  • Üçok, A., Polat, A., Çakır, S., & Genç, A. (2006). One year outcome in first episode schizophrenia. European Archives of Psychiatry and Clinical Neuroscience, 256(1), 37–43.

    Article  PubMed  Google Scholar 

  • Verdoux, H., Tournier, M., & Bégaud, B. (2010). Antipsychotic prescribing trends: a review of pharmaco-epidemiological studies. Acta Psychiatrica Scand., 121, 4–10.

    Article  CAS  Google Scholar 

  • Vigod, S. N., Kurdyak, P. A., Dennis, C. L., Leszcz, T., Taylor, V. H., Blumberger, D. M., & Seitz, D. P. (2013). Transitional interventions to reduce early psychiatric readmissions in adults: systematic review. The British Journal of Psychiatry, 202(3), 187–194.

    Article  PubMed  Google Scholar 

  • Werneck, A. P., Hallak, J. C., Nakano, E., & Elkis, H. (2011). Time to rehospitalization in patients with schizophrenia discharged on first generation antipsychotics, non-clozapine second generation antipsychotics, or clozapine. Psychiatry Research, 188(3), 315–319.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Epidemiology, University of Nebraska Medical Center, 984395 Nebraska Medical Center, Omaha, NE, 68198-4395, USA

    Katherine Rieke & Shinobu Watanabe-Galloway

  2. CHI Health, Omaha, NE, USA

    Corey McGeary

  3. Department of Biostatistics, University of Nebraska Medical Center, Omaha, NE, USA

    Kendra K. Schmid

Authors
  1. Katherine Rieke
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Corey McGeary
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kendra K. Schmid
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Shinobu Watanabe-Galloway
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Katherine Rieke.

Ethics declarations

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Rieke, K., McGeary, C., Schmid, K.K. et al. Risk Factors for Inpatient Psychiatric Readmission: Are There Gender Differences?. Community Ment Health J 52, 675–682 (2016). https://doi.org/10.1007/s10597-015-9921-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10597-015-9921-1

Keywords

Search

Navigation