title: Efficacy of continuous follow-up for preventing the involuntary readmission of psychiatric patients in Japan: a retrospective cohort study.
abstract: BACKGROUND
  Providing aftercare to psychiatric inpatients is important for preventing frequent readmissions; however, the lack of social resources is a problem in Japan. The prefectural Tama-Fuchu Public Health Centre has attempted to establish a new continuous follow-up system for all discharged psychiatric patients in order to reduce the frequency of readmissions.
  
  
  OBJECTIVE
  This study aims to evaluate the efficacy of this system.
  
  
  METHODS
  The subjects of the present study were 200 psychiatric inpatients from the Tokyo catchment area. The continuous follow-up system was applied to 130 subjects for one year in addition to conventional standard care (the intervention group). Seventy subjects received conventional care alone (the comparison group). The incident rate ratios (IRR) of total and involuntary readmission to hospital were compared by survival analysis.
  
  
  RESULTS
  During the observation period, there were 41 readmissions and 29 involuntary readmissions in 49,731 person-days. The patients subjected to continuous follow-up showed a trend towards a lower overall risk of readmission (IRR = 0.56, 95% CI: 0.29-1.10, p = .057) and a significantly reduced risk of involuntary admission (IRR = 0.48, 95% CI: 0.22-0.96, p = .047).
  
  
  CONCLUSIONS
  This study provides empirical evidence that providing continuous follow-up examinations as aftercare for discharged psychiatric patients significantly reduces the incidence of involuntary readmission.
authors.affiliation: Tama-Fuchu Public Health Centre, Tokyo Metropolitan Government, Tokyo 169-0045, Japan. Hiroyuki_Kikuchi@member.metro.tokyo.jp
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kikuchi
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Abo
authors.forename: Emi
authors.initials: E
authors.lastname: Kumakura
authors.forename: Noriko
authors.initials: N
authors.lastname: Kubota
authors.forename: Misako
authors.initials: M
authors.lastname: Nagano
mesh_terms: D000359:Aftercare / Q000379:methods* / Q000523:psychology*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000523:psychology / Q000628:therapy*; D008875:Middle Aged; D010359:Patient Readmission / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012306:Risk; D014041:Tokyo; D016896:Treatment Outcome