Changes in Revolving-Door Mental Health Hospitalizations during the COVID-19 Pandemic: A 5-Year Chart Review Study

Abstract

This study assessed changes in revolving-door (RD) mental health hospitalizations during the COVID-19 pandemic. A 5-year retrospective hospital chart review was performed, collecting revolving-door hospitalization, sociodemographic, and clinical data. Out of 1036 patients, 5.69% had RD hospitalizations, which accounted for 10.38% of all recorded hospitalizations. Further, a higher number of RD hospitalizations occurred following the pandemic outbreak, which is unlikely to have been a result of the confounding effect of trimester and month of hospitalization. Finally, several sociodemographic and clinical characteristics recurred more frequently in the context of RD hospitalizations, such as being younger, being compulsorily admitted, being an absconding patient, and being referred by a public service. Certain diagnostic categories occurred more frequently among RD hospitalizations, including psychotic, personality, and substance use disorders, as well as intellectual disability. Patients with specific characteristics are more likely to incur in RD hospitalizations, requiring the implementation of supportive treatment plans, especially following the pandemic outbreak.

Keywords: care settings; mental health care; treatment.

Figure 1

Survival probability for revolving-door in days from the first hospitalization of the patient, before and after the onset of COVID-19 pandemic. Kaplan–Meier’s curve with 95% confidence interval; dotted lines indicate a 1-year interval.