Symptom, family, and service predictors of children's psychiatric rehospitalization within one year of discharge.
OBJECTIVE
To investigate predictors of readmission to inpatient psychiatric treatment for children aged 5 to 12 discharged from acute-care hospitalization.


METHODS
One hundred nine children were followed for 1 year after discharge from inpatient care. Time to rehospitalization was the outcome of interest. Predictors of readmission, examined via the Cox proportional hazards model, were symptom and family factors assessed at admission, aspects of psychiatric treatment, and demographic variables.


RESULTS
The Kaplan-Meier rehospitalization risk within 1 year of discharge, taking into account known readmissions and censored observations, was 0.37. Most readmissions (81%) occurred within 90 days of discharge. Four variables contributed simultaneously to predicting readmission risk. More severe conduct problems, harsh parental discipline, and disengaged parent-child relations conferred a higher risk for rehospitalization; these risks were attenuated when parents disclosed higher stress in their parenting roles.


CONCLUSIONS
Findings showed that psychiatric rehospitalization of children is common, most likely in the trimester after discharge, and highly related to both child symptoms and family factors measurable at admission. Results suggest that efforts to improve postdischarge outcomes of children should target the initial period following inpatient care, address vigorously the complex treatment needs of those with severe conduct problems, and aim to improve parent-child relations.
Blader
Joseph C
JC
Department of Psychiatry, Schneider Children's Hospital and Hillside Hospital, North Shore-Long Island Jewish Health System, New Hyde Park, NY, USA. Joseph.Blader@StonyBrook.edu
D002648:Child; D002675:Child, Preschool; D005260:Female; D005544:Forecasting; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000523:psychology* / Q000628:therapy*; D008605:Mental Health Services; D010287:Parent-Child Relations; D010359:Patient Readmission / Q000706:statistics & numerical data*; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012008:Recurrence; D012307:Risk Factors; D016019:Survival Analysis; D014481:United States