The revolving door of mental, neurological, and substance use disorders re-hospitalization in rural KwaZulu-Natal Province, South Africa

Afr Health Sci. 2016 Sep;16(3):817-821. doi: 10.4314/ahs.v16i3.23.

Abstract

Objective: Little is known about the extent of mental, neurological and substance-use (MNS) disorders re-hospitalization in South Africa. We examined the extent of one-year MNS re-hospitalization (MNS-R) in a rural South African primary health care facility (PHCF).

Methods: We conducted a retrospective analysis of hospital administrative data from 10,525 adults discharged from a rural PHCF in KwaZulu-Natal Province, South Africa. Chi-squared tests were utilized to describe MNS-R within one year of an index hospital admission in individuals with MNS, with a sub-analysis also being conducted to describe schizophrenia re-hospitalization (S-R).

Results: The prevalence of MNS and schizophrenia recorded at an index hospitalization was 5% and 1%, respectively. A total of 44/67 (66%) individuals with a diagnosis of MNS at the index hospitalization were classified as having MNS-R during oneyear follow-up period. Half of those diagnosed with schizophrenia at the index hospitalization (6/12 patients) were classified as having S-R during one-year follow-up period. There was a significant association between re-hospitalization outcomes (MNS-R and S-R) and MNS (p<0.01) or schizophrenia diagnosis (p<0.01) at index baseline hospitalization.

Conclusion: The extent of MNS-R and S-R remains relatively high in rural South Africa, and needs further health systems strengthening to prevent revolving door occurrences.

Keywords: Rural mental health; South Africa; administrative data; severe mental illness.

MeSH terms

  • Adolescent
  • Adult
  • Community Mental Health Services*
  • Databases, Factual
  • Female
  • Health Services Accessibility
  • Hospitalization / trends*
  • Humans
  • Male
  • Mental Disorders*
  • Middle Aged
  • Prevalence
  • Retrospective Studies
  • Rural Population*
  • South Africa / epidemiology
  • Substance-Related Disorders*
  • Young Adult