Correlates of psychiatric inpatient readmissions of children and adolescents with mental disorders

Abstract

To identify correlates of psychiatric readmission of youth, we conducted a consecutive, retrospective 1-year cohort study (07.01.2014-06.30.2015) of youth (age\xa0=\xa05-17.9) admitted to psychiatric inpatient facility. Stepwise elimination, multivariable logistic regression analyses were conducted to identify independent correlates of 1-year and 30-day psychiatric readmissions. The Family/Caregiver Interview Tool (FCIT) was given to caregivers of 30-day readmitted youth and analyzed using generalized linear model to predict time to readmission. Altogether, 1231 youth experienced 1534 hospitalizations. The 1-year readmission rate was 32.4%; 30-day readmission rate was 10.2%. Significant independent correlates of readmissions were longer length of stay, higher antipsychotic treatment rates, living closer to the hospital, and comorbid obesity, all accounting for 12.2% of variance. FCIT revealed that caregiver s ability to fill prescription after discharge delayed readmission, while shorter time to follow-up appointment hastened it. Illness exacerbation was responsible for 73% of 30-day readmissions; system of care factors accounted for 13%. Compared to clinicians, caregivers significantly underestimated environment of care factors (including caregiver s mental health) as the primary cause for readmission. Readmissions are common and correlate with illness severity and systems of care factors. Family support services may help reduce readmissions. Hospital-specific qualitative investigation may help identify intervention targets to reduce readmissions.