title: The Revolving Door Phenomenon in an Italian Acute Psychiatric Ward: A 5-Year Retrospective Analysis of the Potential Risk Factors.
abstract: To highlight the revolving door (RD) phenomenon in an acute psychiatric ward, we retrospectively identified the patients hospitalized three or more times in a calendar year from 1/1/2009 to 31/12/2013 as RD patients (RDP). We collected sociodemographic and clinical variables of RDP and statistically analyzed the potential RD risk factors. We divided RDP into "high" and "extremely high" utilizers and evaluated the variables related to more frequent readmissions. RDP represented 5.68% of all patients and their hospitalizations (RDH) 25% of all admissions. The statistically significant risk factors for all RDH were "disability pension," "substance abuse/dependence," "mild/severe aggressiveness," and "psychiatric and social rehabilitative programs". The comparison between "high" and "extremely high" utilizers showed that "manic episodes" and "personality disorders," among the diagnoses, "familial relational conflicts" and "violence/suicidality", among the hospitalization reasons, were statistically significant risk factors for more frequent readmissions. RD phenomenon was greatly affected by severe clinical conditions with social disability.
authors.affiliation: *Department of Mental Health, AUSL-MODENA, Servizio Psichaitrico di Diagnosi e Cure (Service of Psychiatric Diagnosis and Treatment), NOCSAE, Baggiovara; †University of Modena and Reggio Emilia, Policlinico; and ‡Statistics Unit, Department of Diagnostic, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Modena, Italy.
authors.forename: Rosaria
authors.initials: R
authors.lastname: Di Lorenzo
authors.forename: Marco
authors.initials: M
authors.lastname: Sagona
authors.forename: Giulia
authors.initials: G
authors.lastname: Landi
authors.forename: Lisa
authors.initials: L
authors.lastname: Martire
authors.forename: Chiara
authors.initials: C
authors.lastname: Piemonte
authors.forename: Cinzia
authors.initials: C
authors.lastname: Del Giovane
mesh_terms: D000328:Adult; D000374:Aggression; D004651:Employment / Q000523:psychology / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000628:therapy*; D010359:Patient Readmission / Q000706:statistics & numerical data*; D016016:Proportional Hazards Models; D011567:Psychiatric Department, Hospital / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012307:Risk Factors; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000628:therapy