FACTORS PREDICTING 2ND ADMISSION TO AN ACUTE PATIENTS THERAPEUTIC-COMMUNITY

A total of 1437 first admissions to a closed therapeutic community war d from 1977 to 1992 were assessed for subsequent readmissions. The war d had a double function: both crisis intervention and psychosocial reh abilitation. During the follow-up time, 515 (36%) patients were rehosp italized. One-third of the patients (187 cases) were rapidly readmitte d within 3 months of discharge, whereas 328 patients were readmitted l ater, after 3 months. The association of rehospitalization with some p atient and program characteristics was analyzed by the time to an even t analysis (survival analysis), using the Cox regression model. A gene rally increased readmission rate was associated with young age (less t han 23 years), psychosis diagnosis, and active participation in indivi dual therapy. Rapid readmission (within 3 months) was linked to active participation in individual therapy and a poor immediate institutiona l outcome, and it was seen as a clinical necessity in crisis cases eve n though their first treatment episode was partly unsuccessful. Later readmission (after 3 months) was associated with an earlier long stay and a positive institutional outcome; it was seen as a part of the lon g-term psychosocial rehabilitation for patients who had responded well to the therapeutic community. Thus the double function of the ward un der study - crisis intervention and psychosocial rehabilitation - was reflected in these two types of rehospitalization.