Rehospitalization in chronic schizophrenia.
This report on rehospitalization in chronic schizophrenia is based on a 1-year study of the postdischarge experiences of 119 chronic schizophrenics in New York City. The life table method of analysis identified the important role of discharge planning, community treatment compliance, and interpersonal stress in the patient's living environment in determining the number of days postdischarge that the patient remained in the community without further inpatient care. A mathematical model to predict days in hospital over the follow-up period, based on three specific components of time in hospital defined in numerical terms (PR, NR, LSR), was devised and tested. The first component, the experience of rehospitalization (PR), was determined by interpersonal stress, social supports, and aftercare treatment compliance. Adequacy of discharge planning, an intervention designed to link the patient to community treatment services, has its greatest impact in identifying number of rehospitalizations for the rehospitalized group (NR). Aftercare treatment compliance has its greatest effect in relation to length of subsequent rehospitalization episodes (LSR). Test of the model revealed that it can predict time in hospital within less than one half of a standard deviation of observed hospital days in approximately 50% of cases.
Caton
C L
CL
Koh
S P
SP
Fleiss
J L
JL
Barrow
S
S
Goldstein
J M
JM
D000206:Actuarial Analysis; D000293:Adolescent; D000328:Adult; D000359:Aftercare; D002908:Chronic Disease; D003156:Community Mental Health Services; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008433:Mathematics; D008875:Middle Aged; D008962:Models, Theoretical; D010349:Patient Compliance; D010351:Patient Discharge; D010359:Patient Readmission; D011336:Probability; D012559:Schizophrenia / Q000628:therapy*; D012565:Schizophrenic Psychology; D012917:Social Adjustment; D012944:Social Support; D013315:Stress, Psychological / Q000523:psychology