Readmission: a useful indicator of the quality of inpatient psychiatric care

Abstract

Background: The literature is unclear regarding the relationship between hospital outcome (i.e., symptom improvement during a hospital admission) and readmission, questioning the validity of readmission as an indicator of the quality of the previous hospitalization. Thus, the present aim was to examine if hospital outcome is a predictor of readmission and identify the factors that may mask any effects.

Methods: A naturalistic historical study compared the predictors of readmission over the 30 days, 6 months and 5 years following discharge for first-ever admitted inpatients with depression (n=478) to all inpatients regardless of prior hospitalisations and current diagnoses (n=1177).

Results: Hospital outcome, as indicated by changes from admission to discharge in scores on symptom measures, during both first-ever admissions and admissions which are not the first, predicted readmissions over all time periods for all patients, not only those with depression. However, this finding was only significant when hospital outcome was assessed by improvements on a patient-reported symptom measure, and not a clinician-rated measure.

Limitations: The sample included inpatients treated at a private psychiatric hospital and therefore it is unknown if these findings can be generalised to patients treated in a public system.

Conclusions: These findings support that readmission may be a useful indicator of the quality of the previous hospitalization.