title: Five-year follow-up of an acute psychiatric admission cohort in Auckland, New Zealand.
abstract: OBJECTIVE
  This paper describes a follow-up of acute psychiatric hospital contact in Auckland, New Zealand for an admission cohort in the 5-years past an index admission (published in the NZMJ in 2005).
  
  
  METHODS
  A 5-year follow-up study of hospital psychiatric service utilisation by 924 patients admitted (index admission) in Auckland during 2000. Hospital admissions within New Zealand for this population were extracted from electronic records. Relevant demographic information (gender, age and ethnicity) and clinical data (primary diagnosis at index admission and admission history) were included for each person. Descriptive analysis of inpatient data and negative binomial regression models were conducted.
  
  
  RESULTS
  Of 924 patients, 38.5% had no readmissions anywhere in New Zealand in the 5-years following index discharge. 41.0% were readmitted within 12 months and 61.4% were readmitted within 5 years of index discharge. Only 5.6% experienced an admission every year for the 5-years post index admission. Readmission was least likely for those with index discharge diagnosis of depression. A history of admissions prior to index admission and Maori ethnicity were characteristics associated with higher numbers of readmission. Those who were younger, or a diagnosis of schizophrenia/schizoaffective disorder or previous admissions tended to have longer total length of stay over the 5-years.
  
  
  CONCLUSIONS
  More than a third of patients had no further hospital contact and the two factors associated with readmission were a history of previous admissions and Maori ethnicity. Reliable community-based data needs to be a priority to enable exploration of community service utilisation and impact of service alternatives to hospital for acute care.
authors.affiliation: Clinical Research and Resource Centre, Mental Health and Addiction Services, Waitemata District Health Board, Auckland, New Zealand. amanda.wheeler@waitematadhb.govt.nz
authors.forename: Amanda
authors.initials: A
authors.lastname: Wheeler
authors.forename: Stuart
authors.initials: S
authors.lastname: Moyle
authors.forename: Carol
authors.initials: C
authors.lastname: Jansen
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Robinson
authors.forename: Jane
authors.initials: J
authors.lastname: Vanderpyl
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D001714:Bipolar Disorder / Q000453:epidemiology; D015331:Cohort Studies; D003863:Depression / Q000453:epidemiology; D005006:Ethnicity; D005260:Female; D005500:Follow-Up Studies; D006778:Hospitals, Psychiatric; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009520:New Zealand / Q000453:epidemiology; D010343:Patient Admission / Q000706:statistics & numerical data; D010359:Patient Readmission / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012559:Schizophrenia / Q000453:epidemiology; D055815:Young Adult