PREDICTING READMISSION TO THE PSYCHIATRIC-HOSPITAL IN A MANAGED CARE ENVIRONMENT - IMPLICATIONS FOR QUALITY INDICATORS

Objective: This study examined predictors of hospital readmission to d etermine whether readmissions can serve as a quality indicator for an inpatient psychiatric service. Method: A series of 255 patients consec utively admitted to any of seven psychiatric hospitals in a regional m anaged care program were followed to determine whether they were readm itted within 6 months of discharge. Case managers assessed patients wi th the use of a reliable outcome management/decision support system de signed for acute psychiatric services. Results: Patients with greater impairment in self-care, more severe symptoms, and more persistent ill nesses were more likely to be readmitted than other patients. Suicidal patients were less likely to be readmitted. There was no evidence to suggest that poor hospital outcome or premature discharge was associat ed with readmission either within 30 days or within 6 months. Conclusi ons: Although patients at risk for hospital admission can be identifie d, it does not appear that the success of the hospital intervention pe r se influences the likelihood of readmission. Use of readmission rate s as quality indicators for hospital care providers is not recommended .