title: Predicting rehospitalization and outpatient services from administration and clinical databases.
abstract: The study tests whether psychiatric services utilization may be predicted from administrative databases without clinical variables equally as well as from databases with clinical variables. Persons with a psychiatric hospitalization at an urban medical center were followed for 1 year postdischarge (N = 1384.) Dependent variables included statewide rehospitalization and the number of hours of outpatient services received. Three linear and logistic regression models were developed and cross-validated: a basic model with limited administrative independent variables, an intermediate model with diagnostic and limited clinical indicators, and a full model containing additional clinical predictors. For rehospitalization, the clinical cross-validated model accounted for twice the variance accounted by the basic model (adjusted R2 = .13 and .06, respectively). For outpatient hours, the basic cross-validated model performed as well as the clinical model (adjusted R2 = .36 and .34, respectively). Clinical indicators such as assessment of functioning and co-occurring substance use disorder should be considered for inclusion in predicting rehospitalization.
authors.affiliation: Washington Institute for Mental Illness Research and Training, Washington State University, 310 N. Riverpoint Blvd., P. O. Box 1495, Spokane, WA 99210, USA. hendryx@wsu.edu
authors.forename: Michael S
authors.initials: MS
authors.lastname: Hendryx
authors.forename: Joan E
authors.initials: JE
authors.lastname: Russo
authors.forename: Bruce
authors.initials: B
authors.lastname: Stegner
authors.forename: Dennis G
authors.initials: DG
authors.lastname: Dyck
authors.forename: Richard K
authors.initials: RK
authors.lastname: Ries
authors.forename: Peter
authors.initials: P
authors.lastname: Roy-Byrne
mesh_terms: D000328:Adult; D003156:Community Mental Health Services / Q000706:statistics & numerical data; D020000:Decision Support Systems, Clinical; D003660:Decision Support Systems, Management; D017831:Diagnosis, Dual (Psychiatry); D005260:Female; D005544:Forecasting; D006301:Health Services Needs and Demand / Q000639:trends; D006786:Hospitals, Urban / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology*; D008875:Middle Aged; D010359:Patient Readmission / Q000706:statistics & numerical data* / Q000639:trends; D011567:Psychiatric Department, Hospital / Q000706:statistics & numerical data*; D040442:Public Health Informatics; D012189:Retrospective Studies; D014861:Washington / Q000453:epidemiology