Factors Associated with Readmissions to a Child Psychiatric Inpatient Unit

Abstract

ABSTRACT Readmission of youth to psychiatric inpatient care has several negative consequences, including increased risk of suicide and need for more frequent hospitalizations, disruption of education, and high cost of care for families as well as hospitals. Previously identified factors predicting readmission to psychiatric inpatient care for youth have included a wide variety of clinical diagnoses, indicating inconsistency in the association between diagnoses and risk of readmission. Instead, the current study focuses on behavioral definitions derived from chief complaints for psychiatric inpatient readmissions. The present study explores the relationship between chief complaint and readmission for patients ages 5–12 who were readmitted within 30 days post-discharge and over 30 days post-discharge from an inpatient psychiatric unit. Results demonstrated that when compared to patients without aggression as their identified chief complaint, patients whose chief complaint was identified as aggression-only and aggression-plus-other-factors were more likely to be readmitted within 30 days post-discharge and to have significantly more 30-day readmissions. Additionally, compared to patients without SI as their identified chief complaint, patients with SI-only as their identified chief complaint were found to be less likely to be readmitted within 30 days and have significantly fewer 30-day readmissions. These results suggest that physical aggression is a unique factor that may increase the risk of readmission for patients 5–12 years old. The results may be particularly useful in identifying crucial treatment components when establishing standards of care for inpatient psychiatric units, though further investigation is needed.