Short stay unit for patients in acute mental health crisis: A case-control study of readmission rates

Asia Pac Psychiatry. 2020 Mar;12(1):e12376. doi: 10.1111/appy.12376. Epub 2019 Dec 27.

Abstract

Introduction: Past evaluations of psychiatric short stay units have shown positive outcomes for patients, yet very little is known about the factors related to readmissions.

Methods: A Short Stay Pathway (SSP) has been introduced on the Gold Coast, Australia, for patients in acute mental health crisis with admissions of up to 3 days. Rates of readmissions within 28 days were compared for SSP patients (N = 678), and a diagnosis-matched control group of patients from acute mental health beds (N = 1356). Demographic and clinical factors were considered as predictors of subsequent readmissions.

Results: Average length of stay for SSP patients was 3.4 days, compared to 7.6 days in the control group. 10.6% of SSP patients and 18.4% of the control group were readmitted within 28 days (P < .001). For both groups, a 7-day follow up significantly reduced readmissions (P < .05). Indigenous patients on SSP had higher odds of readmissions than non-Indigenous patients (P < .05), and a diagnosis of a personality disorder increased readmission in the control group but not the SSP group (P < .001).

Discussion: SSP reduced repeated hospitalizations for patients in acute crisis by 42%. An identification of factors related to future admissions can inform future tailoring of this model of care to subgroups of patients.

Keywords: hospitalization; length of stay; mental health; patient readmission; psychiatry.

MeSH terms

  • Acute Disease
  • Adult
  • Aftercare / organization & administration
  • Aftercare / statistics & numerical data*
  • Case-Control Studies
  • Delivery of Health Care
  • Female
  • Humans
  • Length of Stay / statistics & numerical data*
  • Male
  • Mental Disorders / therapy*
  • Mental Health Services / organization & administration*
  • Mental Health Services / statistics & numerical data*
  • Middle Aged
  • Patient Readmission / statistics & numerical data*
  • Queensland