title: Examining the impact of comorbid serious mental illness on rehospitalization among medical and surgical inpatients.
abstract: Multiple barriers to quality health care may affect the outcomes of postacute treatment for individuals with serious mental illness (SMI). This study examined rehospitalization for medical and surgical inpatients with and without a comorbid diagnosis of SMI which included psychotic disorders, bipolar disorder and major depression.
  
  
  
  We examined hospital discharge records for medical and surgical inpatients from a large urban health system. Descriptive statistics and logistic regression models compared 7-, 30-, 60-, 90- and 180-day rehospitalization among medical and surgical inpatients with SMI (n=3221) and without an SMI diagnosis (n=70,858).
  
  
  
  Within 6 months following discharge, hospitalized medical patients without an SMI diagnosis (34.3%) and with an SMI diagnosis (43.4%) were rehospitalized (P<.001), while surgical patients without an SMI diagnosis (20.3%) and with an SMI diagnosis (30.0%) were rehospitalized (P<.001). Odds of rehospitalization among medical patients were 1.5 to 2.4 times higher for those with an SMI diagnosis compared to those without an SMI diagnosis (P<.001).
  
  
  
  Medical patients with a comorbid psychotic or major mood disorder diagnosis have an increased likelihood of a medical rehospitalization as compared to those without a comorbid SMI diagnosis. These findings support prior literature and suggest the importance of identifying targeted interventions aimed at lowering the likelihood of rehospitalization among inpatients with a comorbid SMI diagnosis.
authors.affiliation: Northeastern University School of Nursing, Bouvé College of Health Sciences, 102 Robinson Hall, 360 Huntington Ave., Boston, MA, 02115. Electronic address: n.hanrahan@neu.edu.
authors.forename: Nancy P
authors.initials: NP
authors.lastname: Hanrahan
authors.affiliation: Graduate School of Social Work and Social Research, Bryn Mawr College, 300 Airdale Road, Bryn Mawr, PA, 19010. Electronic address: sbressi@brynmawr.edu.
authors.forename: Sara
authors.initials: S
authors.lastname: Bressi
authors.affiliation: University of Pennsylvania School of Social Policy & Practice, Center for Mental Health Policy and Services Research, 3701 Locust Walk, Caster Building, Room C16, Philadelphia, PA, 19104-6214. Electronic address: marcuss@sp2.upenn.edu.
authors.forename: Steven C
authors.initials: SC
authors.lastname: Marcus
authors.affiliation: University of Pennsylvania School of Social Policy & Practice, Center for Mental Health Policy and Services Research, 3701 Locust Walk, Caster Building, Room C16, Philadelphia, PA, 19104-6214. Electronic address: solomonp@sp2.upenn.edu.
authors.forename: Phyllis
authors.initials: P
authors.lastname: Solomon
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001714:Bipolar Disorder / Q000453:epidemiology*; D015897:Comorbidity; D003865:Major Depressive Disorder / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission / Q000706:statistics & numerical data*; D011618:Psychotic Disorders / Q000453:epidemiology*; D013514:Surgical Procedures, Operative / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: Major mood disorders; Psychotic disorders; Rehospitalization; Serious mental illness