Factors associated with patient readmission to a specialised psychiatric hospital in the Eastern Cape

Abstract

Background: Hospital readmissions increase healthcare system costs and can place additional strain on already sparse government funds and under-resourced hospitals. Few studies have investigated readmission of patients in mental health facilities in South Africa. Aim: The study aimed to identify the factors associated with readmission of patients discharged from an acute psychiatric public hospital in South Africa. Setting: The study was conducted at an acute psychiatric public hospital. Method: A retrospective review of medical records was conducted for all patients admitted and readmitted between January 2018 and December 2019. Results: From the pool of patient records analysed (n = 516), 93 (18.02%) were readmitted, of which the majority (75.27%) were male. The average age of patients readmitted was 27.24 +- 11.16 years, which was significantly younger than the total sample (p < 0.05; CI 1.095-7.105). Findings indicated that patients who completed lower levels of education, were unemployed and were diagnosed with substance (mono- or polysubstance) use disorder (n = 93; 100%), schizophrenia (n = 33; 35.48%), bipolar disorder (n = 9; 9.68%) or intellectual disability (n = 9; 9.68%) were more frequently readmitted, with the average length of stay varying widely between patients. Younger patients and those living with more complex psychiatric conditions, particularly those who are substance abusers, were readmitted more frequently, indicating that these patients may require special consideration for management. Contribution: The study revealed that patients living with complex psychiatric conditions such as schizophrenia and bipolar disorder were readmitted to hospital more frequently, indicating that management of these patients at the community level is challenging.