title: Predictors of psychiatric re-hospitalization in older adults with severe mental illness.
abstract: OBJECTIVE
  Many patients with severe recurrent mental illness are approaching late life; however, little is known about psychiatric re-hospitalization in this population. Our objective was to identify predictors of psychiatric re-hospitalization.
  
  
  METHODS
  This was a retrospective cohort study of all 226 geriatric patients (age ≥65 years) admitted to a tertiary care Canadian inpatient psychiatric unit between 2003 and 2008. The main outcome was psychiatric re-hospitalization in 5-year follow-up post-discharge (e.g. 2008-2013 if a patient had been first admitted in 2008). Multivariate Cox regression analyses were used to identify potential predictors of re-hospitalization.
  
  
  RESULTS
  Over 5-year follow-up, 32.3% (73/226) required psychiatric re-hospitalization. Prior lifetime history of psychiatric admission, currently living in a supervised setting and bipolar disorder diagnosis all independently predicted a lower time to psychiatric re-hospitalization (HRs > 2.0, p < 0.05).
  
  
  CONCLUSIONS
  The rate of psychiatric re-hospitalization is high in older adults admitted for severe mental illness. Clinicians should be aware of the especially high rates of re-hospitalization in geriatric psychiatric inpatients with bipolar disorder, previous psychiatric admissions, or those living in a supervised setting. Future research could investigate approaches to prevent psychiatric re-hospitalization in these vulnerable sub-populations.
authors.affiliation: Geri-PARTy Research Group, Department of Psychiatry, Jewish General Hospital, McGill University, Montreal, Canada.
authors.forename: Ching
authors.initials: C
authors.lastname: Yu
authors.affiliation: Geri-PARTy Research Group, Department of Psychiatry, Jewish General Hospital, McGill University, Montreal, Canada.
authors.forename: Jean-Daniel
authors.initials: JD
authors.lastname: Sylvestre
authors.affiliation: Geri-PARTy Research Group, Department of Psychiatry, Jewish General Hospital, McGill University, Montreal, Canada.
authors.forename: Marilyn
authors.initials: M
authors.lastname: Segal
authors.affiliation: Geri-PARTy Research Group, Department of Psychiatry, Jewish General Hospital, McGill University, Montreal, Canada.
authors.forename: Karl J
authors.initials: KJ
authors.lastname: Looper
authors.affiliation: Geri-PARTy Research Group, Department of Psychiatry, Jewish General Hospital, McGill University, Montreal, Canada.|Department of Psychiatry, University of Toronto, Toronto, Canada.
authors.forename: Soham
authors.initials: S
authors.lastname: Rej
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002170:Canada; D015897:Comorbidity; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay; D008297:Male; D001523:Mental Disorders / Q000628:therapy*; D008605:Mental Health Services / Q000706:statistics & numerical data*; D008875:Middle Aged; D010359:Patient Readmission / Q000706:statistics & numerical data*; D012044:Regression Analysis; D012189:Retrospective Studies; D012307:Risk Factors
keywords: geriatric psychiatry; health service utilization; psychiatric re-hospitalization; severe mental illness