Pattern of health service utilization and predictors of readmission after a first admission for psychosis: a 2-year follow-up study.
ABSTRACT To explore the pattern of health service utilization over 2 years following a first admission for psychosis and the baseline characteristics predicting readmission.
Patients included in a cohort of first-admitted subjects with psychosis (n = 84) were assessed at the end of a 2-year follow-up using multiple sources of information.
At the end of the follow-up, one of three subjects had no contact with any mental health professional, and 38% of subjects had no contact with a psychiatrist. Half of the patients were readmitted over the 2-year follow-up. The baseline characteristics independently predicting psychiatric readmission were a high number of helping contacts before first admission and persistence of psychotic symptoms at discharge.
Decreasing the frequency of readmission in the early course of psychosis is a public health priority. Development of psychotherapeutic programs for subjects with early psychosis who have enduring psychotic symptoms at first discharge should be promoted.
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ABSTRACT: Electroconvulsive therapy (ECT) is an effective treatment for major mental illnesses. It is used to achieve rapid and short-term improvement of severe symptoms after an adequate trial of other treatment options have proven ineffective. Relapse rates following ECT are high and leading to early readmission. Objective: To study the early readmission rate in patients had received ECT and its relation with age, gender, race and clinical diagnosis. Methods: This is a retrospective descriptive study of patients who had received ECT in 1-year period. Subjects were identified from the ECT record book. Case notes of these patients were then traced and reviewed. Clinical diagnosis and demographic data were collected. Patients readmitted within 6 months after being discharged were identified. The data was compared for the readmitted and not readmitted group. Result: A total of 156 subjects who had received ECT were included in this study. Mean age was 40 years old, 51% were female and the main diagnosis was bipolar affective disorder (42.9%). Early readmission rate was 30.1%. Mean time to relapse was 5.3 months. Chi Square analysis indicated that younger age was significantly associated with early readmission among ECT patients. Conclusion: ECT patients had high early readmission rate. Adequate post ECT psychosocial intervention and pharmacotherapy may help to reduce the readmission rate.
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ABSTRACT: OBJECTIVE This study examined the predictors of inpatient hospital admission after early intervention for psychosis services (EIPS) treatment. Specifically, the study examined the sociodemographic and clinical factors that were associated with hospital admissions in the two years after discharge from EIPS. METHODS The characteristics of 231 patients enrolled in an EIPS program in Christchurch, New Zealand, between 2000 and 2005 were examined. Information about post-EIPS hospital admissions was obtained from the New Zealand Health Information Service. Poisson regression models were used to estimate bivariate and multivariate associations between number of post-EIPS hospital admissions and a range of predictors, including hospitalization history. RESULTS A majority of patients (78%) were hospitalized before or during EIPS treatment, and 29% were hospitalized after the program. Older age, Māori ethnicity, a domestic partnership at referral, lower Global Assessment of Functioning scores, and hospitalization before and during treatment were significant predictors of the number of post-EIPS hospitalizations. CONCLUSIONS The results of the study suggest that the number of hospital admissions after participation in the EIPS program may be reduced by addressing issues related to the cultural appropriateness of treatment, engagement with partners and families, and overall adjustment and functioning and by efforts to limit hospitalization before and during EIPS treatment.Psychiatric services (Washington, D.C.) 09/2013; 64(12). DOI:10.1176/appi.ps.201200388 · 2.81 Impact Factor