Purpose: The goal of the project was to determine why patients are being hospitalized repeatedly within an acute psychiatric facility. Past studies have found repeated hospitalization leads to economic drain, disability, poor outcome, stigma and discrimination. Repeated hospitalizations are one of the main causes of disability and dysfunction amongst the mentally ill as well as consuming more than 90 % of the mental health budget. This drain deprives consumers of a major part of allocated health resources. Identifying the potential risk factors for repeated hospitalization, interrelationships between risk factors, and vulnerability will help us take the appropriate measures to prevent hospitalization and promote care in the community. Logistically there are three possible factors which may lead to repeated hospitalization: 1. Characteristics of the patient, 2. Nature of the illness and, 3. The management of the illness which includes system in, administrative patients care. This prospective study which was conducted at the Regional Mental Health Care - St Thomas has the objective to delineate some of these factors. This study aims to find the risk factors, psychosocial correlates and clinical profiles of patients being hospitalized repeatedly. Methods: Methods: We recruited consenting patients with repeated hospitalization from the inpatient and outpatient programs. These patients were assessed using structured and unstructured psychometric tools to examine demography, psychopathology of psychosis, depression, life events, current psychosocial stress, resilience, nature of treatment and community care. We administered and recorded routine clinical date, brief psychiatric rating scale, Hamilton depression rating scale, Holms and Rahe scale of presumptive life events, life event questionnaire, Connor-Davidson RESILINCE scale(CD-RISK) and suicidality by SISMAP. Results: We are presenting findings of the pilot phase of this study. The results show that there are significant patient-related factors e.g experience of trauma, chronic suicidality and unremitted symptoms which are the primary cause of rehospitalisation. The nature of the illness, the nature of treatment and systemic issues are not significantly involved in re-hospitalisation.
no difference in resilience, amongst one admission (n=12) versus more than one admission (n=22) (CD RISK-Total 49.1 Vs.51.7 p=.657,CD-RISK >40, 10 Vs.17 p >.999; CD-RISK >60 , 3 Vs 5 p >.999) Resilience was did not show any correlation with number of previous hospitalization on any parameter of psyhcosis, depression,suicdality,stressful situations,) except la negative correlation with ife events in past one year ( r=-0.357, p=.038)
Besides level of baseline resilience had positive correlation with stressful situation ( HRSS; r =0.405, p=.036) and life events in previous one year (r=0.406, p=.017), negative correlation with Suicidality (SISMAP; r=-0.424, p=.12) Lower level of resilience ( CD-RISK <60,)was significantly correlated with high level of Suicidality as measured by SISMAP ( 35.1 Vs 22.8 p=.004 )
Conclusions: A preventive strategy needs to address specific areas of vulnerabilities in a given patient. Completion of the study is expected to provide a broad range of information to prevent repeated hospitalizations. Expected Outcomes: Understanding of the factors which can be treated to prevent repeated hospitalization.
Available at: http://works.bepress.com/amreshsrivastava/113/