Mental Health

Nearly a fifth of elderly patients are readmitted after a hospital stay for psychiatric care

Older patients with psychiatric conditions often receive treatment in outpatient settings, but patients with severe symptoms often need inpatient care. A new study finds that 22 percent of elderly patients who were treated at and released from hospitals end up back in the hospital within 6 months. Researchers found that the readmission rate for patients suffering from schizophrenia and bipolar disorder was about 50 percent higher than for patients who were depressed or had substance abuse disorders.

Patients who had two or more psychiatric conditions were at greater risk for readmission than patients who had just one condition. However, patients who had some medical conditions and a psychiatric condition were less likely to be readmitted. The authors suggest that these patients' need for treatment of their medical conditions may outweigh their psychiatric concerns, or their regular contact with health care providers may help them avoid psychiatric hospitalizations.

Hospital stays of 5 days or longer decreased the chances that patients with affective disorders (for example, depression or bipolar disorder) would be rehospitalized. Twenty-nine percent of patients with affective disorders who had stays of 4 or fewer days were readmitted, while just 16 percent with nonaffective disorders (for example, anxiety or substance abuse) were rehospitalized. The findings indicate that to prevent readmissions, patients should not be prematurely discharged, especially those with affective disorders Patients could also benefit from tailored discharge plans and aftercare, suggest the authors, who used 2002 Medicare data for 41,839 patients for this study.

The study was funded in part by the Agency for Healthcare Research and Quality (HS16097) to the Rutgers Center for Education and Research on Therapeutics (CERT). For more information on the CERTs program, please visit http://www.ahrq.gov/clinic/certsovr.htm.

See "Psychiatric rehospitalization among elderly persons in the United States," by Jonathan D. Prince, Ph.D., Ayse Akincigil, Ph.D., Ece Kalay, B.A., and others in the September 2008 Psychiatric Services 59(9), pp. 1038-1045.

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