Past Issues

Factors Affecting the Readmission Rate after Psychiatric Home Treatment

Jen-Hung Huang, Li-Chung Huang, Yue-Cune Chang, Kuo-Jung Chang, Yueh-Ming Tai

Objective:The objective of this study was to explore the factors associated with differences in hospital admission rates before and after psychiatric home treatment in Taiwan. Specifically, this study was to focus on social, demographic, clinical, and service-related factors. Methods:We recruited 97 convenient samples of patients who received psychiatric home treatment from either the Beitou Branch, Tri-Service General Hospital (Beitou Branch, TSGH) in Taipei, Taiwan, or Chiayi Christian Hospital (CCH) in Chiayi, Taiwan. The data were collected from the participants’ home treatment medical records and from data of interviews with their case managers to assess the effects of several factors on the numbers of hospital admissions before and after home treatment. Results:A generalized, multivariate linear model revealed that more frequent hospital admissions were significantly associated with more difference in admission after home treatment (p< 0.001). In addition, higher Clinical Global Impressions-Severity (CGI-S) scores (p < 0.001) and a criminal history (p< 0.01 in univariate analysis, and p< 0.05 in multivarate anlysis) were significantly associated with less improved hospital admission. The most important predictors of improvements in hospital admission rates after home treatment in Taiwan were the previous admission rate, CGI-S score and criminal history. Previous admission positively predicts the improvement in hospital admission whereas CGI-S and criminal history predict negatively. Conclusion:Our findings of this study suggest that home treatment should be encouraged among patients with higher rates of previous hospital admissions. In addition to home treatment, other adjuvant interventions should be used for patients with high CGI-S scores or criminal records to reduce the likelihood of future hospitalization.
Key Word home treatment, psychiatric readmission, community mental health, chronic mental disorder
Editorial Committe, Taiwanese Journal of Psychiatry
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