title: The outcomes of psychiatric inpatients by proportion of experienced psychiatrists and nurse staffing in hospital: New findings on improving the quality of mental health care in South Korea.
abstract: Readmission rates for mental health care are higher in South Korea than other Organization for Economic Development (OECD) countries. Therefore, it is worthwhile to continue investigating how to reduce readmissions. Taking a novel approach, we determined the relationship between psychiatrist experience and mental health care readmission rates. We used National Health Insurance claim data (N=21,315) from 81 hospitals to analyze readmissions within 30 days of discharge for "mood disorders" or "schizophrenia, schizotypal and delusional disorders" during 2010-2013. In this study, multilevel models that included both patient and hospital-level variables were analyzed to examine associations with readmission. Readmissions within 30 days of discharge accounted for 1079 (5.1%) claims. Multilevel analysis demonstrated that the proportion of experienced psychiatrists at a hospital was inversely associated with risk of readmission (OR: 0.79, 95% CI: 0.74-0.84 per 10% increase in experienced psychiatrists). Readmission rates for psychiatric disorders within 30 days of discharge were lower in hospitals with a higher number of nurses (OR: 0.95, 95% CI: 0.94-0.96 per 10 nurses). In conclusion, health policymakers and hospital managers should make an effort to reduce readmissions for psychiatric disorders and other diseases by considering the role that physician experience plays and nurse staffing.
authors.affiliation: Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea; Institute of Health Services Research, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Kyu-Tae
authors.initials: KT
authors.lastname: Han
authors.affiliation: Department of Health Administration and Management, College of Medical Science, Soonchunhyang University, Asan, Korea.
authors.forename: Sun Jung
authors.initials: SJ
authors.lastname: Kim
authors.affiliation: Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea; Institute of Health Services Research, Yonsei University College of Medicine, Seoul, Republic of Korea; Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Sung-In
authors.initials: SI
authors.lastname: Jang
authors.affiliation: Department of Health Administration and Management, Soonchunhyang University, Asan, Republic of Korea.
authors.forename: Myung-Il
authors.initials: MI
authors.lastname: Hahm
authors.affiliation: Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea; Institute of Health Services Research, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Seung Ju
authors.initials: SJ
authors.lastname: Kim
authors.affiliation: Institute of Health Services Research, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Seo Yoon
authors.initials: SY
authors.lastname: Lee
authors.affiliation: Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea; Institute of Health Services Research, Yonsei University College of Medicine, Seoul, Republic of Korea; Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea. Electronic address: ecpark@yuhs.ac.
authors.forename: Eun-Cheol
authors.initials: EC
authors.lastname: Park
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006778:Hospitals, Psychiatric / Q000592:standards / Q000706:statistics & numerical data*; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data; D008297:Male; D008605:Mental Health Services / Q000592:standards* / Q000706:statistics & numerical data; D008875:Middle Aged; D009313:National Health Programs; D017063:Outcome Assessment, Health Care; D010351:Patient Discharge / Q000706:statistics & numerical data; D010359:Patient Readmission / Q000706:statistics & numerical data*; D010561:Personnel Staffing and Scheduling; D011568:Psychiatric Nursing / Q000706:statistics & numerical data*; D011570:Psychiatry / Q000706:statistics & numerical data*; D056910:Republic of Korea; D055815:Young Adult
keywords: Experienced physicians; Nurse staffing; Psychiatric disorders; Psychiatrists; Readmission