Risk of readmission in compulsorily and voluntarily admitted patients.
OBJECTIVE
The aim of this study is to examine relationships between hospital admission legal status (voluntary, psychiatrist-ordered, and court ordered), length of stay and risk of hospital readmission.


METHODS
The records (1994-2005) of all consecutive admissions (n = 16,016) to one inpatient mental health facility were reviewed. Patients (n = 6,656) were classified into 3 groups at first admission: voluntary (n = 5,442), psychiatrist-ordered (n = 1,067) and court ordered (n = 147).


RESULTS
The probability of readmission of the court-ordered and psychiatrist-ordered groups were significantly lower than that of voluntarily admitted patients (P < 0.05). The length of stay at first admission was significantly longer for the court-ordered group than for the others (P < 0.001). As compared with the other groups, court ordered-patients were significantly younger (P < 0.001), had attained fewer years of education (P < 0.001) and included a lower percentage of immigrants (P < 0.05). Significant differences were found in the mean morality age of the three groups (P < 0.005).


CONCLUSIONS
As compared with psychiatrist-ordered and voluntarily admitted patients, court ordered patients have a lower probability for hospital readmission, possibly related to longer length of stay.
Valevski
Avi
A
Geha Psychiatric Hospital and Felsenstein Medical Research Center, Beilinson Campus, Petah Tiqva, Israel. valevski@post.tau.ac.il
Olfson
Mark
M
Weizman
Abraham
A
Shiloh
Roni
R
D000328:Adult; D000704:Analysis of Variance; D003134:Commitment of Persons with Psychiatric Disorders / Q000706:statistics & numerical data*; D005260:Female; D006778:Hospitals, Psychiatric / Q000706:statistics & numerical data*; D006801:Humans; D007557:Israel; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D016347:Medical Records Systems, Computerized; D028642:Persons with Psychiatric Disorders / Q000145:classification / Q000331:legislation & jurisprudence*; D008875:Middle Aged; D010343:Patient Admission / Q000706:statistics & numerical data*; D010359:Patient Readmission / Q000706:statistics & numerical data*; D012044:Regression Analysis; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D014600:Utilization Review
Acta Psychiatr Scand. 1987 Nov;76(5):552-60
3434327
Health Care Manag (Frederick). 2003 Apr-Jun;22(2):122-7
12785549
Soc Psychiatry Psychiatr Epidemiol. 2001 Jun;36(6):304-9
11583461
Br J Psychiatry. 2003 Feb;182:105-16
12562737
Soc Psychiatry Psychiatr Epidemiol. 1998 Nov;33(11):528-34
9803820
J Nerv Ment Dis. 1999 Dec;187(12):721-9
10665466
Psychiatr Prax. 2001 Jul;28(5):226-9
11479829
Psychiatr Serv. 1999 Aug;50(8):1049-52
10445653
Hosp Community Psychiatry. 1989 Aug;40(8):820-3
2759572
Isr J Psychiatry Relat Sci. 2004;41(2):133-9
15478459
Psychiatr Serv. 2005 Jul;56(7):867-9
16020822
Acta Psychiatr Scand. 2002 Jul;106(1):3-8
12100342
Br J Psychiatry. 2006 Apr;188:386-91
16582067
BMJ. 2005 Jan 15;330(7483):123-6
15567803
Schizophr Res. 1991 Jan-Feb;4(1):1-9
2009251
Am J Psychiatry. 1993 Jan;150(1):72-6
8417584
J Nerv Ment Dis. 1984 Jul;172(7):412-6
6144721
N Engl J Med. 2005 Sep 22;353(12 ):1209-23
16172203
Med Sci Law. 2005 Apr;45(2):129-34
15895638
Psychol Rep. 2003 Dec;93(3 Pt 1):816-8
14723448
Soc Psychiatry Psychiatr Epidemiol. 1999 Dec;34(12):627-33
10703272
Acta Psychiatr Scand. 2005 May;111(5):358-66
15819729
Am J Psychiatry. 1996 Mar;153(3):392-6
8610828
Psychiatr Serv. 1999 Jun;50(6):806-12
10375151
Psychiatr Serv. 2003 Sep;54(9):1271-6
12954945
Am J Psychiatry. 1999 Dec;156(12):1968-75
10588412
Psychiatr Serv. 1998 Aug;49(8):1049-53
9712211