Risk factors for early unplanned readmission in patients with bipolar disorder: A retrospective observational study

Daisuke Shinjo, Hisateru Tachimori, Keiko Maruyama-Sakurai, Tetsu Ohnuma, Kenji Fujimori, Kiyohide Fushimi

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3 Citations (Scopus)


Objectives: Evidence regarding the relationships between patient, hospital, and regional factors and early unplanned readmission (short-term outcome) in patients with bipolar disorder is lacking. This study aimed to examine risk factors associated with early unplanned readmission in patients with bipolar disorder. Method: We retrospectively analyzed adult bipolar patients (ICD-10; F31) between April 2012 and March 2014 in the Japanese Diagnosis Procedure Combination database. We examined factors affecting the 30-day unplanned readmission using multivariable logistic regression analysis. Results: A total of 2688 patients admitted to psychiatric beds were included. Multivariate analysis showed that unchanged or exacerbation discharge outcome (adjusted odds ratio [aOR]: 1.93; 95% confidence interval [CI]: 1.06–3.51, p = 0.031), unplanned or urgent admission settings (aOR: 1.51; 95% CI: 1.00–2.26, p = 0.048), physical comorbidity (chronic pulmonary disease) (aOR: 4.74; 95% CI: 1.30–17.29, p = 0.018), presence of psychiatric acute-care beds (aOR: 1.72; 95% CI: 1.02–2.87, p = 0.040), and intermediate-level hospital psychiatric staffing (aOR: 1.82; 95% CI: 1.14–2.91, p = 0.012) were significantly associated with higher early unplanned readmission, while higher density of psychiatrists in the area (aOR: 0.50; 95% CI: 0.29–0.87, p = 0.014) was significantly associated with lower early unplanned readmission. Conclusions: The results suggest that not only careful management of high-risk patients but also consideration of functional differentiation in psychiatric inpatient care, psychiatric resource allocation, and follow-up support for patients with bipolar disorder are needed for reducing the early unplanned readmission rate.

Original languageEnglish
Pages (from-to)51-58
Number of pages8
JournalGeneral Hospital Psychiatry
Publication statusPublished - 2019 May 1


  • Administrative database
  • Bipolar disorder
  • Japan
  • Unplanned readmission


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