TY - JOUR
T1 - Risk factors for early unplanned readmission in patients with bipolar disorder
T2 - A retrospective observational study
AU - Shinjo, Daisuke
AU - Tachimori, Hisateru
AU - Maruyama-Sakurai, Keiko
AU - Ohnuma, Tetsu
AU - Fujimori, Kenji
AU - Fushimi, Kiyohide
N1 - Funding Information:
This study was supported by a Grant-in-Aid for Young Scientists (B) from the Japan Society for the Promotion of Science , Japan (JSPS KAKENHI, Grant Number 16K19284 ), and a Grant-in-Aid for Research on Policy Planning and Evaluation from the Ministry of Health, Labour and Welfare , Japan ( H28-Seisaku-Shitei-009 ).
Publisher Copyright:
© 2019
PY - 2019/5/1
Y1 - 2019/5/1
N2 - 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.
AB - 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.
KW - Administrative database
KW - Bipolar disorder
KW - Japan
KW - Unplanned readmission
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U2 - 10.1016/j.genhosppsych.2019.03.003
DO - 10.1016/j.genhosppsych.2019.03.003
M3 - Article
C2 - 30913417
AN - SCOPUS:85063300491
SN - 0163-8343
VL - 58
SP - 51
EP - 58
JO - General Hospital Psychiatry
JF - General Hospital Psychiatry
ER -
