Duration of first admission and its relation to the readmission rate in a psychiatry hospital

BACKGROUND: Most psychiatric illnesses have a chronic relapsing course. It is estimated that the readmission rate for discharged patients is approximately 40-50% within one year of their discharge from the hospital. The current emphasis in mental health service is on brief hospitalization and providing community-based services. AIM: To understand the relationship between the duration of first hospital admission and the rates of readmission in a psychiatry hospital. MATERIALS AND METHODS: All the patients admitted at Asha hospital, Hyderabad for the first time between 16 September, 2003 to 15 March, 2004, were included in the study. The hospital records of these patients were examined and the data was collected on various variables, which included demographic variables, duration of hospital stay, diagnosis, and the number of readmissions for a period of approximately three-and-a-half years. The duration of the first hospital stay was divided into four categories, Group 1:1-7 days, Group 2:8 to 14 days, Group 3:15 to 30 days, and Group 4: More than 30 days. RESULTS: The sample consisted of 516 patients, out of whom 17 were excluded because of insufficient data. Two hundred and fifty patients belonged to Group 1 (1 to 7 days), 206 patients in Group 2 (8 to 14 days), Group 3 (15 to 30 days) constituted 35 patients, and eight patients were in Group 4 (>30 days). CONCLUSION: The length of the initial hospital stay is important to prevent future hospitalization. There are no definite predictors for readmission that could be detected, except for the length of the initial admission in the study.