4-YEAR FOLLOW-UP OF THE INFLUENCE OF PSYCHOLOGICAL COMORBIDITY ON MEDICAL REHOSPITALIZATION

Objective: This study tested the hypothesis that psychiatric comorbidi ty measured in medical and surgical general hospital inpatients predic ts increased readmissions and days spent rehospitalized at the same ho spital up to 4 years after discharge. Method: A convenience sample of 273 medical/surgical inpatients aged 18 years and older were given psy chological tests during their third to fifth hospital days on medical and surgical units from June 1, 1985, through June 30, 1986. The main outcome measure was the number of medical/surgical readmissions and nu mber of days rehospitalized during a 4-year follow-up at the same inst itution. Results: Compared to the rest of the study group, the cogniti vely impaired patients (according to the Mini-Mental State examination ) averaged twice as many rehospitalizations and three times as many da ys rehospitalized at 6-month follow-up and twice as many days rehospit alized at 2-year follow-up. Compared to the rest of the group, the pat ients who were depressed or who had high interpersonal sensitivity sco res at the index admission spent twice as many days rehospitalized dur ing the 4-year follow-up, while the patients with high hostility score s had almost twice as many readmissions. These results remained statis tically significant after separate partialing out Of the effects of se verity of functional impairment, age, cognitive impairment, and number of admissions or days spent hospitalized before the Index admission. Conclusions: Psychiatric comorbidity, previously well documented as co ntributing to increased length of stay in the general hospital, is ass ociated with increased hospital utilization for at least 4 years after discharge.