Associations between readmission and patient-reported measures in acute psychiatric inpatients: a multicenter prospective longitudinal study.

IF 3.6 2区医学 Q1 PSYCHIATRY

Social Psychiatry and Psychiatric Epidemiology Pub Date : 2025-01-01 Epub Date: 2024-08-05 DOI:10.1007/s00127-024-02710-5

Sosei Yamaguchi, Yasutaka Ojio, Junko Koike, Asami Matsunaga, Makoto Ogawa, Akiko Kikuchi, Takahiro Kawashima, Hisateru Tachimori, Peter Bernick, Hiroshi Kimura, Ataru Inagaki, Hiroyuki Watanabe, Yoshiki Kishi, Koji Yoshida, Takaaki Hirooka, Satoru Oishi, Yasuhiro Matsuda, Chiyo Fujii

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引用次数: 0

Abstract

Purpose: This study examined whether patient-reported measures (PRMs) addressing quality of life, personal agency, functional impairment, and treatment satisfaction at hospital discharge were associated with future readmission during a 12-month follow-up period. The study also examined whether readmission influenced changes in the same measures.

Methods: A multicenter prospective cohort study was conducted at 21 psychiatric hospitals in Japan. Participants completed the EuroQol-five-dimensions-five-level (EQ-5D), the Five-item Subjective Personal Agency Scale, and the Sheehan Disability Scale (SDS) at the time of index admission (T1), discharge from index admission (T2), and 6 months (T3) and 12 months (T4) after discharge. Inpatient treatment satisfaction was assessed at T2. Readmission and variables potentially associated with hospitalization and PRMs were evaluated using mixed-effects logistic regression models and mixed models for repeated measures.

Results: A total of 491 participants were followed for 12 months (attrition rate: 19.4%), and 480 were included in the EQ-5D analysis. The most common diagnoses were schizophrenia (59%), depression (14%), and bipolar disorder (13%). No patient-reported measures were significantly associated with readmission over the follow-up period. Interaction of readmission and time did not significantly affect changes in EQ-5D. Readmission did significantly influence SDS score changes between T2 and T3 (B = 1.78, 95% CI = 0.30-3.25, p = 0.018) and between T3 and T4 (B = 1.43, 95% CI = 0.14-2.72, p = 0.029). The same influence of readmission on SDS score changes was not observed in the model which adjusted for all potential covariates.

Conclusion: Readmission was potentially associated with changes in self-reported functional impairment. Findings highlight the potential role of intensive post-discharge services in preventing readmission, rather than relying on time-of-discharge PRMs in order to predict readmission risk.

Trial registration: This study was registered in UMIN Clinical Trials Registry (UMIN000034220).

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急性期精神病住院患者再入院与患者报告指标之间的关系：一项多中心前瞻性纵向研究。

目的：本研究探讨了患者报告的有关出院时生活质量、个人代理、功能障碍和治疗满意度的指标（PRMs）是否与 12 个月随访期间的再入院相关。该研究还探讨了再次入院是否会影响这些指标的变化：在日本 21 家精神病院开展了一项多中心前瞻性队列研究。受试者在入院时（T1）、出院时（T2）、出院后 6 个月（T3）和 12 个月（T4）分别完成了 EuroQol 五维五级量表（EQ-5D）、五项主观个人代理量表和 Sheehan 残疾量表（SDS）。住院治疗满意度在 T2 时进行评估。使用混合效应逻辑回归模型和重复测量混合模型评估了再入院情况以及与住院和 PRMs 可能相关的变量：共有 491 名参与者接受了 12 个月的随访（自然减员率：19.4%），其中 480 人被纳入 EQ-5D 分析。最常见的诊断为精神分裂症（59%）、抑郁症（14%）和双相情感障碍（13%）。在随访期间，没有患者报告的指标与再入院显著相关。再入院与时间的交互作用对 EQ-5D 的变化无明显影响。再入院确实会明显影响 T2 和 T3 之间的 SDS 评分变化（B = 1.78，95% CI = 0.30-3.25，p = 0.018）以及 T3 和 T4 之间的 SDS 评分变化（B = 1.43，95% CI = 0.14-2.72，p = 0.029）。在调整了所有潜在协变量的模型中，未观察到再入院对SDS评分变化的相同影响：结论：再次入院可能与自我报告的功能障碍变化有关。研究结果强调了出院后强化服务在预防再入院方面的潜在作用，而不是依靠出院时间的PRM来预测再入院风险：本研究已在UMIN临床试验注册中心注册（UMIN000034220）。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Social Psychiatry and Psychiatric Epidemiology 医学-精神病学

CiteScore

8.50

自引率

2.30%

发文量

184

审稿时长

3-6 weeks

期刊介绍： Social Psychiatry and Psychiatric Epidemiology is intended to provide a medium for the prompt publication of scientific contributions concerned with all aspects of the epidemiology of psychiatric disorders - social, biological and genetic. In addition, the journal has a particular focus on the effects of social conditions upon behaviour and the relationship between psychiatric disorders and the social environment. Contributions may be of a clinical nature provided they relate to social issues, or they may deal with specialised investigations in the fields of social psychology, sociology, anthropology, epidemiology, health service research, health economies or public mental health. We will publish papers on cross-cultural and trans-cultural themes. We do not publish case studies or small case series. While we will publish studies of reliability and validity of new instruments of interest to our readership, we will not publish articles reporting on the performance of established instruments in translation. Both original work and review articles may be submitted.