High risk factors for rehospitalization within six months |
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Authors: | Ray Walker M.D. Debra Minor-Schork R.N. M.S.N. Richard Bloch Ph.D. James Esinhart Ph.D. |
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Affiliation: | (1) Psychiatric Unit, University Medical Center, Greenville, North Carolina;(2) Department of Psychiatric Medicine, East Carolina University School of Medicine, Carolia, USA;(3) Glaxo, Inc., Research Triangle Park, North Carolina, Carolia, USA;(4) Department of Psychiatry, ECU School of Medicine, 27858-4354 Greenville, North Carolina |
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Abstract: | Objective. 1. To identify risk factors associated with psychiatric rehospitalization within six months, using global clinical assessments and demographic information and; 2. To determine if risk factors for a hospital in a rural region are similar to those reported for urban hospitals. Method. The setting was a psychiatric unit within a general hospital. All adult admissions for one year were assigned scores on the North Carolina Functional Assessment Scale (NCFAS) and the Global Assessment of Functioning (GAF) scale. Patients were interviewed six months after discharge to determine if they had been rehospitalized and to assign new NCFAS and GAF scores. Results. Significant risk of rehospitalization was predicted by: 1. NCFAS score >90; 2. history of prior hospitalization; 3. nursing home residence; 4. referral from a small community hospital and; 5. non-compliance with outpatient appointments. Conclusions. Global assessments and demographic information collected during an index admission can generate factors to identify patients at risk for rehospitalization within six months. History of prior admissions and non-compliance with outpatient treatment, reported as risk factors in urban settings, were found also to be risk factors in a rural region.He was formerly Assistant Professor, Center for Health Sciences Statistics, East Carolina University School of Medicine. |
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