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Gen Hosp Psychiatry. 2018 Jul - Aug;53:44-51. doi: 10.1016/j.genhosppsych.2018.05.003. Epub 2018 May 4.

Patient and health system factors associated with hospital readmission in older adults without cognitive impairment.

Author information

1
Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke (QC), Canada and Charles-Le Moyne Hospital Research Center, Greenfield Park, (QC), Canada. Electronic address: Helen-Maria.Vasiliadis@USherbrooke.ca.
2
Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, (QC), Canada. Electronic address: Raymond.Milan@USherbrooke.ca.
3
Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, (QC), Canada.
4
Department of Psychiatry, McGill University, Montreal, (QC), Canada and Douglas Mental Health University Institute Research Centre, Montreal, (QC), Canada. Electronic address: Marie-Josee.Fleury@douglas.mcgill.ca.

Abstract

OBJECTIVE:

To study the factors associated with hospital readmission.

METHODS:

Data used in this study came from a population-based survey of older adults without cognitive impairment. Cox regression was used to assess the factors associated with readmission within a 2-year follow-up period. According to Andersen's model of healthcare seeking behavior, study variables considered included predisposing, enabling and need factors at the individual and health system levels.

RESULTS:

Of the 433 participants with an index hospitalization, 97% were discharged with a physical and 3% with a psychiatric disorder. During follow-up, 29% (128/433) were readmitted with a median time to readmission reaching 83 days. The risk of readmission was associated with the following: age, marital status, attraction index of the region of residence for psychiatric services, the presence of an anxio-depressive and other mental disorder, as well as a disorder of the musculoskeletal system. The presence of a physical and psychiatric comorbidity was also associated with readmission.

CONCLUSIONS:

Post-discharge follow-up of vulnerable populations with a history of mental disorders and improved availability of psychiatric services in the community are associated with a reduced risk of readmission.

KEYWORDS:

Comorbidity; Health system; Older adults; Patient factors; Physical disorders; Psychiatric disorders; Readmission

[Indexed for MEDLINE]

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