FACTORS ASSOCIATED WITH MULTIPLE ADMISSIONS TO A PUBLIC PSYCHIATRIC-HOSPITAL

The purpose of this study was to identify the psychiatric and social f actors associated with multiple admissions, especially for psychotic p atients. Demographic and diagnostic information (based on the DSM-III- R) was collected on a computerized database for all patients admitted to the only psychiatric hospital in Geneva, Switzerland. Patients who had had at least three admissions over a period of 1 year were compare d with a control group drawn from the total clinic population. In 1994 , a total of 1575 patients were hospitalized, and 18% of these patient s were readmitted for the third or more time. The principal diagnoses were psychotic disorders (25%), affective disorders (35%) and substanc e-related disorders (24%). The predictors of multiple admissions for p sychotic patients were a comorbidity of substance-related disorder, lo nger duration of illness, female sex, younger age and poorer psychosoc ial adjustment during the past year. These results highlight the usefu lness of a computerized psychiatric database. Indeed, early identifica tion of the types of psychiatric patient who are likely to be readmitt ed is necessary to enable the planning and implementation of specific programmes of ambulatory care to prevent rehospitalization.