title: Risk Factors for Readmission on an Adult Inpatient Psychiatric Unit.
abstract: OBJECTIVE
  Readmission rates have been proposed as a possible quality metric for inpatient psychiatry. Little is known about predicting readmissions and identifying modifiable factors that may reduce early readmissions in these settings.
  
  
  METHODS
  We reviewed 693 medical records from our adult inpatient psychiatric unit to identify factors associated with patients' readmission within 90 days of discharge.
  
  
  RESULTS
  After adjusting for all variables, and including interactions between identified factors, we found several demographic features predicting readmission, including male gender with suicidal ideation on admission (odds ratio [OR] = 13.2; 95% confidence interval [CI], 3.4-51.9), a diagnosis of a psychotic disorder with a prior medical admission (OR = 5.7; 95% CI, 1.7-20.6), and suicidal ideation with comorbid personality disorder (OR = 5.3; 95% CI, 1.4-20.6). Demographic features decreasing the odds of readmission included being non-white with homeless living situation (OR = 0.18; 95% CI, 0.04-0.82), medication changes made within 48 hours of discharge (OR = 0.44; 95% CI, 0.23-0.84), and the number of medications dispensed without documented follow-up plan or appointment (OR = 0.88; 95% CI, 0.81-0.96).
  
  
  CONCLUSIONS
  Future prospective studies utilizing qualitative and quantitative methods are required to more precisely define a wider array of metrics. Improved identification of demographic features associated with early readmissions may suggest areas to target as we seek to the quality of inpatient psychiatric care.
authors.affiliation: Departments of Behavioral Health (Drs Rylander, Hamalian, Lozano, and Nussbaum) and Internal Medicine (Dr Rylander and Ms Keniston), Denver Health, Denver, Colorado; and Department of Psychiatry, University of Colorado School of Medicine, Aurora (Dr Colon-Sanchez).
authors.forename: Melanie
authors.initials: M
authors.lastname: Rylander
authors.forename: Dayan
authors.initials: D
authors.lastname: Colon-Sanchez
authors.forename: Angela
authors.initials: A
authors.lastname: Keniston
authors.forename: Gareen
authors.initials: G
authors.lastname: Hamalian
authors.forename: Abby
authors.initials: A
authors.lastname: Lozano
authors.forename: Abraham M
authors.initials: AM
authors.lastname: Nussbaum
mesh_terms: D000328:Adult; D015897:Comorbidity; D003266:Continuity of Patient Care / Q000458:organization & administration; D005260:Female; D006703:Ill-Housed Persons; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000628:therapy*; D008875:Middle Aged; D016017:Odds Ratio; D010359:Patient Readmission / Q000706:statistics & numerical data*; D011446:Prospective Studies; D011567:Psychiatric Department, Hospital / Q000458:organization & administration* / Q000706:statistics & numerical data*; D011787:Quality of Health Care; D012307:Risk Factors; D012737:Sex Factors; D012959:Socioeconomic Factors; D059020:Suicidal Ideation