Hostname: page-component-8448b6f56d-sxzjt Total loading time: 0 Render date: 2024-04-24T09:17:14.874Z Has data issue: false hasContentIssue false
  • English
  • Français

Hospitalisation for schizophrenia in acute psychiatric wards of the Lazio region: a 4-year follow-up study

Published online by Cambridge University Press:  11 October 2011

Andrea Gaddini ,
Francesco Franco ,
Domenico Di Lallo  and
Lilia Biscaglia
Andrea Gaddini*
Affiliation:
Agenzia di Sanità Pubblica della Regione Lazio, Roma
Francesco Franco
Affiliation:
Agenzia di Sanità Pubblica della Regione Lazio, Roma
Domenico Di Lallo
Affiliation:
Agenzia di Sanità Pubblica della Regione Lazio, Roma
Lilia Biscaglia
Affiliation:
Agenzia di Sanità Pubblica della Regione Lazio, Roma
*
Address for correspondence: Dr. A. Gaddini. Unità Operativa Salute Mentale, Agenzia di Sanità Pubblica della Regione Lazio, Via di Santa Costanza 53, 00198, Roma. Fax: +39-06-830-60.463 E-mail: gaddini@asplazio.it
Get access Rights & Permissions [Opens in a new window]

Summary

Aim – To determine the rates of psychiatric hospitalisation and to evaluate the predictors of readmissions in a cohort of 887 schizophrenic patients at their “first” psychiatric admission. Methods – Data were collected using the hospital dis-charge database of the Lazio region, Italy. The cohort included patients admitted to a psychiatric ward in 1999, with a main diagnosis of schizophrenia and no prior psychiatric hospitalisation during the 5 years preceding the index admission. Psychiatric read-missions were considered up to year 2004. Kaplan-Meier survival curves and logistic procedures were performed to estimate the cumulative readmission incidence and ORs of readmissions for potential confounders. Results – During the 4-year follow-up, 44.3% of the patients were readmitted at least once. An active treatment among community psychiatric facilities at the time of index admission predicted a higher readmission risk. However, for those who experienced their first admission in a private ward read-mission risk was consistently higher, whether or not having had such a treatment. Conclusions – Risk of readmission in a psychiatric ward appears to be related to the level of integration with mental health community facilities, while length of stay is strongly affected by service system variables. Possible uses of medical information systems in this field are described.

Declaration of Interest: none.

Keywords

schizophreniapatient readmissionmedical record linkagecohort study
Type
Original Articles
Information
Epidemiology and Psychiatric Sciences , Volume 14 , Issue 4 , December 2005 , pp. 227 - 234
Copyright
Copyright © Cambridge University Press 2005

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

BIBLIOGRAFIA

Agenzia di Sanita Pubblica della Regione Lazio (2002). Sistema Informativo Ospedaliero. Retrieved June 14. 2005. from http://www.asplazio.it/asp_online/att_ospedaliera/sio/sio_index.phpGoogle Scholar
Bruffaerts, R., Sabbe, M. & Demyttenaere, K. (2004). Effects of patients and Health-system characteristics on community tenure of discharged psychiatric inpatients. Psychiatric Senices 55, 685–690.Google ScholarPubMed
Di Lallo, D., Gaddini, A. & Perucci, C. (Eds.) (2000). L'Attività di Ricovero nei Reparti Psichiatrici Pubbtici e Privati del Lazio. Anno 1999. Agenzia di Sanità Pubblica della Regione Lazio: Roma. Retrieved June 14. 2005. from http://www.asplazio.it/asp_online/tut_soggetti_deb/salute_mentale/s_mentale_pubblicazioni.phpGoogle Scholar
Di Lallo, D., Gaddini, A., Franco, F. & Guasticchi, G. (Eds.) (2003). L'Attività di Ricovero nei Reparti Psichialrici Pubbiici e Privati del Lazio. Anno 2002. Agenzia di Sanità Pubblica della Regione Lazio: Roma. Retrieved June 14. 2005. from http://www.asplazio.it/asp_online/tut_soggetti_deb/salute_mentale/s_mentale_pubblicazioni.phpGoogle Scholar
Eaton, W.W., Mortensen, P.B., Herrman, H., Freeman, H., Bilker, W., Burgess, P. & Wooff, K. (1992). Long-term course of hospitalization for schizophrenia: Part I. Risk for rehospitalization. Schizophrenia Bulletin 18, 217–228.Google Scholar
Fisher, W.H., Geller, J.L., Altaffer, F. & Bennett, M.B. (1992). The relationship between community resources and state hospital recidivism. American Journal of Psychiatry 149, 385–390.Google Scholar
Gaddini, A., Franco, F., Di Lallo, D. & Biscaglia, L. (Eds.) (2005). L'Attività di Ricovero Ordinario e di Day Hospital nei Reparti Psichiatrici del Lazio. Anno 2003. Agenzia di Sanità Pubblica della Regione Lazio: Roma. Retrieved June 14. 2005. from http://www.asplazio.it/asp_online/tut_soggetti_deb/salute_mentale/s_mentale_pubblicazioni.phpGoogle Scholar
Gater, R., Goldberg, D., Jackson, G., Jennatt, N., Lowson, K., Ratcliffe, J., Saraf, T. & Warner, R. (1997). The care of patients with chronic schizophrenia: a comparison between two services. Psychological Medicine 27, 1325–1336.Google Scholar
Hafner, H. (2000). Onset and early course as determinants of the further course of schizophrenia. In The Psxchosocial Basis of Schizophrenia (ed. Munk-Jørgensen, P.). Acta Psychiatrica Scandinavica. Supplementum 407. vol. 102. pp. 44–48.Google Scholar
An der Heiden, W. & Hafner, H. (2000). The epidemiology of onset and course of schizophrenia. European Archives of Psychiatry and Clinical Neurosciences 250, 292–303.Google Scholar
Hamilton, L.C. (2003). Statistics with STATA. Updated for Version 7. Duxbury Press: London.Google Scholar
Haro, J.M., Eaton, W.W., Bilker, W.B. & Mortensen, P.B. (1994). Predictability of rehospitalization for schizophrenia. European Archives of Psychiatry and Clinical Neurosciences 244, 241–246.Google Scholar
Hosmer, D.W. & Lemeshow, S. (2002). Applied Logistic Regression. John Wiles & Sons: New YorkGoogle Scholar
Johnson, S., Prosser, D., Bindman, J. & Szmukler, G. (1997). Continuity of care for the severely mentally ill: concepts and measures. Social Psychiatry and Psychiatric Epidemiology 32, 137–142.Google Scholar
Klinkenberg, W.D. & Calsyn, R.J. (1996). Predictors of receipt of after-care and recidivism among persons with severe mental illness: a review. Psychiatric Services 47, 487–496.Google Scholar
Lien, L. (2002). Are readmission rates influenced by how psychiatric services are organized? Nordic Journal of Psychiatry 56, 23–28.Google Scholar
Mattioni, T., Di Lallo, D., Roberti, R., Miceli, M.Stefani, M.Maci, C. & Perucci, C.A. (1999). Determinants of psychiatric inpatient admission to general hospital psychiatric ward: an epideiniological study in a region of central Italy. Social Psychiatry and Psychiatric Epidemiology 34, 425–431.Google Scholar
Ministero della Salute (2001). Personate e Strutture dei Dipartimcnti di Salute Mentale. Rilevazione 2001. Ministero della Salute: Roma.Google Scholar
Mortensen, P.B. & Eaton, W.W. (1994). Predictors for readmission risk in schizophrenia. Psychological Medicine 24, 223–232.Google Scholar
Øiesvold, T., Saarento, O., Sytema, S., Vinding, H., Gostas, G., Lonnerberg, O., Muus, S., Sandlund, M. & Hansson, L. (2000). Predictors for readmission risk of new patients: the Nordic Comparative Study on Sectorized Psychiatry. Acta Psychiatrica Scandinavica 101, 367–373.Google Scholar
Olesen, A.V. & Mortensen, P.B. (2002). Readmission risk in schizophrenia: selection explains previous findings of a progressive course of disorder. Psychological Medicine 32, 1301–1307.Google Scholar
Politi, P., Tagliavini, G., Colleoni, V., Donati, D., Florian, A., Griffi, P.G., Mita, P., Panetta, B. & Ragazzetti, M. (1997). Sulla richiesta di ricovero psichiatrico: i dati di otto SPDC in Lombardia. Epidemiologia e Psichiatria Sociale 6, 69–76.CrossRefGoogle Scholar
Ruggeri, M., Lasalvia, A., Tansella, M., Bonetto, C, Abate, M., Thornicroft, G., Allevi, L. & Ognibene, P. (2004). Heterogeneity of outcomes in schizophrenia. British Journal of Psychiatry 184, 48–57.CrossRefGoogle ScholarPubMed
Skapinakis, P. & Lewis, G. (2001) Epidemiology in community psychiatric research: common uses and methodological issues. Epidemiologia e Psichiatria Sociale 10, 18–25.Google Scholar
Sytema, S., Micciolo, R. & Tansella, M. (1997). Continuity of care for patients with schizophrenia and related disorders: a comparative south-Verona and Groningen case-register study. Psychological Medicine 27, 1355–1362.CrossRefGoogle ScholarPubMed
Sytema, S., Burgess, P. & Tansella, M. (2002). Does community care decrease length of stay and risk of rehospitalization in new patients with schizophrenia disorders? A comparative case register study in Groningen. the Netherlands: Victoria, Australia; and South-Verona, Italy. Schizophrenia Bullettin 28, 273–281.Google Scholar
Thompson, E., Neighbors, H., Munday, C. & Trierweiler, S. (2003). Length of stay, referral to aftercare, and rehospitalization among psychiatric inpatients. Psychiatric Sen'ices 54, 1271–1276.Google Scholar
Vogel, S. & Huguelet, P. (1997). Factors associated with multiple admissions to a public psychiatric hospital. Acta Psvchiatrica Scandinavica 95, 244–253.Google Scholar
Whitehorn, D., Richard, J.C. & Kopala, L.C. (2004). Hospitalization in the first year of treatment for schizophrenia. Canadian Journal of Psychiatry 49, 635–638.Google Scholar