Crisis discharges and readmission risk in acute psychiatric male inpatients

Niehaus, Dana JH; Koen, Liezl; Galal, Ushma; Dhansay, Khalid; Oosthuizen, Piet P.; Emsley, Robin A.; Jordaan, Esme
January 2008
BMC Psychiatry;2008, Vol. 8, Special section p1
Academic Journal
Background: Severe pressures on beds in psychiatric services have led to the implementation of an early ("crisis") discharge policy in the Western Cape, South Africa. The study examined the effect of this policy and length of hospital stay (LOS) on readmission rates in one psychiatric hospital in South Africa. Methods: Discharge summaries of adult male patients (n = 438) admitted to Stikland Psychiatric Hospital during 2004 were retrospectively examined. Each patient's clinical course was then analysed for the period between January 1st, 2004, and August 31st, 2006. Results: Although shorter LOS was associated with decreased readmission rates, the effect of crisis discharges was far more powerful. Patients discharged as usual had a far lower risk of readmission than those discharged due to bed pressures (i.e. crisis discharge). Conclusion: Increased risks associated with the early discharge policy necessitate the urgent review of the current management of bed shortages in this inpatient facility. The strengthening of community initiatives, particularly assertive outreach could be a way forward.


Related Articles

  • Characteristics and Needs of Psychiatric Patients With Prolonged Hospital Stay. Afilalo, Marc; Soucy, Nathalie; Xiaoqing Xue; Colacone, Antoinette; Jourdenais, Emmanuelle; Boivin, Jean-François // Canadian Journal of Psychiatry;Apr2015, Vol. 60 Issue 4, p181 

    Objective: To describe the characteristics and needs prior to, on admission, during the first month in hospital, at the thirtieth day of hospitalization and posthospital discharge of psychiatric patients occupying acute beds. Methods: This prospective observational study was conducted in 2...

  • Psychiatric and Medical Rehabilitation Discharges Skyrocket in New York.  // Health Care Financing Review;Summer98, Vol. 19 Issue 4, p150 

    Reports on the increase of psychiatric and medical rehabilitation discharges from New York City, New York hospitals from 1993 to 1997, according to `Hospital Watch' quarterly report. Decline in total hospital discharges for all other medical services; Factors to which the growth in discharges...

  • Frequently hospitalised psychiatric patients: a study of predictive factors. Korkeila, J. A.; Lehtinen, V.; Tuori, T.; Helenius, H. // Social Psychiatry & Psychiatric Epidemiology;1998, Vol. 33 Issue 11, p528 

    The purpose of this study was to investigate the factors predicting readmission and the interval between readmissions to psychiatric hospital during the early 1990s in Finland. Data were retrieved using the national register of all discharges from psychiatric hospitals during the early 1990s....

  • THE WELCOME BASKET PROJECT: CONSUMERS REACHING OUT TO CONSUMERS. Weingarten, Richard; Chinman, Matthew; Tworkowski, Sophie; Stayner, David; Davidson, Larry // Psychiatric Rehabilitation Journal;Summer2000, Vol. 24 Issue 1, p65 

    Focuses on the Welcome Basket Project, an innovative consumer-run service that connects with consumers in the vulnerable time after their discharge and links them to peer-led activities and community-based services in New Haven, Connecticut. Efforts to start the project; Valued social roles for...

  • Government wants wider legal powers for community care. Groves, Trish // BMJ: British Medical Journal (International Edition);8/21/93, Vol. 307 Issue 6902, p463 

    Focuses on the legal power concerning the community care of psychiatric patients in Great Britain. Necessity of supervised discharge for patients cared by mental health services; Scope of the Mental Health Act of 1983; Concerns of psychiatrists about the proposed supervision power.

  • The mortality of long-stay patients following interhospital relocation. Morriss, Richard K.; Bowie, Peter C. W.; Victoria, P.; Morriss, R K; Bowie, P C; Spencer, P V // British Journal of Psychiatry;May88, Vol. 152, p705 

    The mortality of 99 long-stay psychiatric patients did not significantly increase after interhospital relocation. Preparation for the transfer, and the type of environmental change, seem to be important determinants of outcome in this and other studies.

  • CARACTERIZAÇÃO DOS PACIENTES COM TRANSTORNO OBSESSIVO COMPULSIVO: UM ESTUDO EPIDEMIOLÓGICO*. De Oliveira, Adriana Gonçalves; Da Silva, Juliana Ferreira; Teles, Laura Campos; Machado, Richardson Miranda // Cogitare Enfermagem;out-dez2012, Vol. 17 Issue 4, p676 

    This is a retrospective, exploratory study, undertaken in a psychiatric institution with the aim of characterizing the patients affected by Obsessive-Compulsive Disorder by sex, age, provenance, duration of hospitalization, type of discharge, type of hospitalization, and source of financing of...

  • Cost savings associated with fitness-to-stand-trial assessments in detention centres: a pilot program. Chaimowitz, Gary A; Ferencz, Joseph; Chaimowitz, G A; Ferencz, J // Canadian Journal of Psychiatry;Oct1999, Vol. 44 Issue 8, p808 

    Objective: To determine whether fitness-to-stand-trial assessments "in detention" offer cost benefit over inpatient assessments.Method: The development of a pilot "fitness clinic" in a detention centre is described, and the results of 1 year of assessments are...

  • Acute psychiatric inpatient care for people with a dual diagnosis: patient profiles and lengths of stay. Burge, Philip; Ouellette-Kuntz, Hélène; Saeed, Haider; McCreary, Bruce; Paquette, Dana; Sim, Franklin; Ouellette-Kuntz, Hélène // Canadian Journal of Psychiatry;Apr2002, Vol. 47 Issue 3, p243 

    Objective: This study describes characteristics of psychiatry inpatients with developmental disabilities (DD) and their admissions to psychiatry wards in 2 acute care hospitals. It also compares differences in lengths of stay between admissions of this group with a comparison sample...

  • The contemporary natural history of mental disorder in old age. Blessed, G.; Wilson, J. D.; Wilson, I D // British Journal of Psychiatry;Jul82, Vol. 141, p59 

    A classificatory system for mental disorders in the elderly proposed by Roth in 1955 was examined in a contemporary population. Ninety per cent of patients could be allocated to the five psychosyndromes originally defined. Examination of outcome in the present sample, at six month and two years,...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics