Re-hospitalization which takes place in about 30 to 50% postdischarge patienst, leads to poor outcome, increased rate of mortality and consumes more than 2/3 of budgetary allocations. Inability to identify vulnerable candidates for repeated admissions limits our options for strategic treatment.
In this prospective study conducted at Regional Mental Health Care ( Presently Parkwood Institute) 101 patienst ( 51 feamles, mean age 43 years), were examined using standard psychometric tools on parameters of clinical, psychopathological, suicide behaviour and resiliency for their risk and preventive characerstics.
We assessed 101 subjects (51 females) with mean age of 42 years. 45% were hospitalized more than once, mean number of hospitalization was 6 and duration of illness 5.4 yrs. The study shows that patients having difficulty in accessing health care (20 (51.3%) Vs 0 (0.0%) p=0.053), those who attempted to kill themselves (3 (23.1%) Vs.17 (54.8%) p = 0.054), tried to hurt themselves (6 (30.0%)Vs.14 (58.3%),p=0.060), and felt vulnerable for suicide attempt, feeling that they would be better off dead (7 (31.8%) Vs.13 (59.1%), p=0.069) were hospitalised more than once. Patients who were not reepeatedly hospitalized had high resilience (28 (51.9%) Vs 4 (19.1%) p= 0.010 ), took pride in their acheivement (18 (58.1%) Vs14 (31.8%) p=0.024), had strong sense of purpose (31 (48.4%) Vs. 14 (31.8%), p= 0.024), stayed focussed under pressure (28 (50.0%) Vs 4 (21.1%), p= 0.028), did not give up under pressure (25 (53.2%) Vs 7 (25.0%) p= 0.017) and dealt positively with whatever matter came up (27 (48.2%) Vs. 5 (26.3%) p= 0.095)
Conclusion The study shows that clinical and behavioral risk and preventive factors are significantly related with repeated hospitalization.
Clinical Implication: The study has significant clinical impliation in developing effetive preventive strategy for repeated hospitalization
Available at: http://works.bepress.com/amreshsrivastava/161/