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Factors Associated With Multiple Psychiatric Readmissions for Youth With Mood Disorders.

Authors
  • Phillips, Matthew S1
  • Steelesmith, Danielle L1
  • Campo, John V2
  • Pradhan, Taniya3
  • Fontanella, Cynthia A4
  • 1 College of Medicine and Wexner Medical Center, The Ohio State University, Columbus.
  • 2 The West Virginia University School of Medicine, Morgantown; West Virginia University Rockefeller Neuroscience Institute, Morgantown.
  • 3 The West Virginia University School of Medicine, Morgantown.
  • 4 College of Medicine and Wexner Medical Center, The Ohio State University, Columbus. Electronic address: [email protected]
Type
Published Article
Journal
Journal of the American Academy of Child and Adolescent Psychiatry
Publication Date
May 01, 2020
Volume
59
Issue
5
Pages
619–631
Identifiers
DOI: 10.1016/j.jaac.2019.05.024
PMID: 31170443
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Inpatient psychiatric readmission rates are increasingly considered indicators of quality of care. This study builds upon prior research by examining patient-, hospital-, and community-level factors associated with single and multiple readmissions for youth. A retrospective cohort study was conducted using Medicaid claims data from four states supplemented with the American Hospital Association survey, the Area Resource File, and the National Survey of Mental Health Treatment Services. Multinomial logistic regression examined patient-, hospital-, and community-level factors that were associated with inpatient psychiatric readmission for 6,797 Medicaid-eligible youth with a primary diagnosis of mood disorder using a three-level nominal dependent variable coded as no readmission, one readmission, and two or more readmissions within 6 months after discharge. Six months after initial discharge, 941 youth (13.8%) were readmitted once and 471 (6.9%) were readmitted two or more times. The odds of single or multiple readmissions were significantly higher (p < .05) for youth classified as disabled or in foster care, those with multiple psychiatric comorbidities, medical comorbidity, and prior psychiatric hospitalization. Treatment in hospitals with high percentage of Medicaid discharges and a high number of beds was associated with lower odds of readmission. There was a significant interaction between length of stay and outpatient mental health follow-up within 7 days of discharge. Patient- and hospital-level factors are associated with likelihood of both single and multiple youth inpatient psychiatric readmissions, suggesting potential risk markers for psychiatric readmission. Copyright © 2019 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

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