Operating conditions of psychiatric hospitals and early readmission--effects of high patient turnover.
OBJECTIVE
To study the association between hospitals' operating conditions and the risk of early readmission. The hypothesis was that high patient turnover might lead to a rise in the risk of readmission soon after discharge (within 30 days).


METHODS
A multivariate model including hospital and patient variables was tested using Cox's regression analysis, adjusting for clustering effects. The material included data from 20 hospitals, with 5,520 patients in the final model.


RESULTS
High patient turnover (annual discharges per bed) was significantly associated with an increased risk of readmission (hazard ratio (HR)= 3.37 (95% CI = 2.39-4.75)). In addition, being discharged from a ward with relatively low access to therapists increased the hazard further.


CONCLUSIONS
High patient turnover at the discharging ward was found to increase the patients' hazard of early readmission. This observation supports the hypothesis of a link between the operation conditions of the hospitals and patient outcome on a short time-scale.
SINTEF Unimed NIS Health Services Research, Trondheim, Norway.
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Heggestad
D000328:Adult; D005260:Female; D006778:Hospitals, Psychiatric / Q000458:organization & administration* / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000534:rehabilitation*; D008605:Mental Health Services / Q000706:statistics & numerical data*; D009664:Norway; D010351:Patient Discharge / Q000706:statistics & numerical data*; D010359:Patient Readmission / Q000706:statistics & numerical data*; D012307:Risk Factors; D013997:Time Factors