Does the Hospital Predict Readmission? A Multi-level Survival Analysis Approach.
Time to psychiatric rehospitalization was predicted for a sample of 1473 Medicaid-insured youth in Illinois in 2005 and 2006. A multi-level model statistical strategy was employed to account for the fact that youth days to rehospitalization were nested within hospital and to test the hypothesis that hospitals would vary significantly in return rates, controlling for individual-level (e.g., symptom, demographic) variables. Hospitals did not vary significantly in days to rehospitalization. At the individual-level, level of externalizing behavior and residential treatment placement predicted a faster return to the hospital. These results support the perspective that hospital outcomes are best operationalized using variables tied more directly to the inpatient episode (e.g., LOS, reductions in acuity).
Department of Psychology, Loyola University Chicago, 1032 West Sheridan Road, Coffey Hall, 203, Chicago, IL, 60626, USA. sleon@luc.edu.
Scott C
SC
Leon
Department of Psychology, Loyola University Chicago, 1032 West Sheridan Road, Coffey Hall, 203, Chicago, IL, 60626, USA.
Alison M
AM
Stoner
Department of Psychology, Loyola University Chicago, 1032 West Sheridan Road, Coffey Hall, 203, Chicago, IL, 60626, USA.
Daniel A
DA
Dickson
D000293:Adolescent; D001007:Anxiety / Q000453:epidemiology / Q000628:therapy; D019958:Attention Deficit and Disruptive Behavior Disorders / Q000453:epidemiology / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D019955:Conduct Disorder / Q000453:epidemiology / Q000628:therapy; D003863:Depression / Q000453:epidemiology / Q000628:therapy; D005260:Female; D006778:Hospitals, Psychiatric / Q000706:statistics & numerical data*; D006801:Humans; D007175:Impulsive Behavior; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000628:therapy*; D055361:Multilevel Analysis; D010359:Patient Readmission / Q000706:statistics & numerical data*; D019984:Quality Indicators, Health Care; D012114:Residential Treatment / Q000706:statistics & numerical data; D012307:Risk Factors; D012652:Self Mutilation / Q000453:epidemiology / Q000628:therapy; D012720:Severity of Illness Index; D016019:Survival Analysis; D013997:Time Factors; D055815:Young Adult
Inpatient psychiatric care; Multilevel survival analysis; Psychiatric readmission; Psychiatric rehospitalization