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Article
Risk Factors for Early Readmission to Acute Care for Persons with Schizophrenia taking Antipsychotic Medications
Psychiatric Services
  • Timothy Boaz, University of South Florida
  • Marion A. Becker, University of South Florida
  • Ross Andel, University of South Florida
  • Richard Van Dorn, RTI International, Research Triangle Park
  • Jiyoon Choi, Ortho-McNeil Janssen Scientific Affairs
  • Mirko Sikirica, Ortho-McNeil Janssen Scientific Affairs
Document Type
Article
Publication Date
12-1-2013
Digital Object Identifier (DOI)
https://doi.org/10.1176/appi.ps.003382012
Abstract

Objective

The study examined risk factors for readmission to acute care among Florida Medicaid enrollees with schizophrenia treated with antipsychotics. Methods

Medicaid and service use data for 2004 to 2008 were used to identify adults with schizophrenia discharged from hospitals and crisis units who were taking antipsychotics. Data were extracted on demographic characteristics, service use before admission, psychopharmacologic treatment after discharge, and readmission to acute behavioral health care. Cox proportional hazards regression estimated readmission risk in the 30 days after discharge and in the period after 30 days for participants not readmitted in the first 30 days. Results The mean±SD age of the 3,563 participants was 43.4±11.1; 61% were male, and 38% were white. Participants had 6,633 inpatient episodes; duration of hospitalization was 10.6±7.0 days. Readmission occurred for 84% of episodes, 23% within 30 days. Variables associated with an increased readmission risk in the first 30 days were shorter hospitalization (hazard ratio [HR]=1.18, 95% confidence interval [CI]=1.10–1.27, p<.001), shorter time on medication before discharge (HR=1.19, CI=1.06–1.35, p=.003), greater prehospitalization use of acute care (HR=2.64, CI=2.29–3.05, p<.001), serious general medical comorbidity (HR=1.21, CI=1.06–1.38, p=.005), and prior substance abuse treatment (HR=1.58, CI=1.37–1.83, p<.001). After 30 days, hospitalization duration and time on medication were not significant risk factors. Conclusions

Short hospital stays for persons with schizophrenia may be associated with risk of early readmission, possibly because the person is insufficiently stabilized. More chronic risk factors include prior acute care, general medical comorbidity, and substance abuse.

Citation / Publisher Attribution

Psychiatric Services, v. 64, issue 12, p. 1225-1229

Citation Information
Timothy Boaz, Marion A. Becker, Ross Andel, Richard Van Dorn, et al.. "Risk Factors for Early Readmission to Acute Care for Persons with Schizophrenia taking Antipsychotic Medications" Psychiatric Services Vol. 64 Iss. 12 (2013) p. 1225 - 1229
Available at: http://works.bepress.com/timothy_boaz/10/