Examining the Impact of Comorbid Serious Mental Illness on Rehospitalization among Medical and Surgical Inpatients

Abstract Objective Multiple barriers to quality health care may affect the outcomes of post-acute treatment for individuals with serious mental illness (SMI). This study examined rehospitalization for medical and surgical inpatients with and without a comorbid diagnosis of SMI which included psychot...

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Bibliographic Details
Published in:General hospital psychiatry 2016-09, Vol.42, p.36-40
Main Authors: Hanrahan, Nancy P., PhD, RN, FAAN, Bressi, Sara, Ph.D., L.S.W, Marcus, Steven C., PhD, Solomon, Phyllis, PhD
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Bipolar Disorder - epidemiology
Comorbidity
Depressive Disorder, Major - epidemiology
Female
Humans
Major mood disorders
Male
Middle Aged
Patient Readmission - statistics & numerical data
Psychiatry
Psychotic disorders
Psychotic Disorders - epidemiology
Rehospitalization
Serious mental illness
Surgical Procedures, Operative - statistics & numerical data
Young Adult
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Summary:Abstract Objective Multiple barriers to quality health care may affect the outcomes of post-acute treatment for individuals with serious mental illness (SMI). This study examined rehospitalization for medical and surgical inpatients with and without a comorbid diagnosis of SMI which included psychotic disorders, bipolar disorder, and major depression. Methods We examined hospital discharge records for medical and surgical inpatients from a large urban health system. Descriptive statistics and logistic regression models compared 7, 30, 60, 90, and 180 day rehospitalization among medical and surgical inpatients with SMI (n = 3221) and without a SMI diagnosis (n = 70,858). Results Within six months following discharge, hospitalized medical patients without a SMI diagnosis (34.3%) and with a SMI diagnosis (43.4%) were rehospitalized ( P < .001) while surgical patients, without a SMI diagnosis (20.3%) and with a SMI diagnosis (30.0%) were rehospitalized ( P < .001). Odds of rehospitalization among medical patients were 1.5 to 2.4 times higher for those with a SMI diagnosis compared to those without a SMI diagnosis ( P < .001). Conclusions Medical patients with a comorbid psychotic or major mood disorder diagnosis have an increased likelihood of a medical rehospitalization as compared to those without a comorbid SMI diagnosis. These findings support prior literature and suggest the importance of identifying targeted interventions aimed at lowering the likelihood of rehospitalization among inpatients with a comorbid SMI diagnosis.
ISSN:0163-8343
1873-7714
DOI:10.1016/j.genhosppsych.2016.06.002