Are readmission rates influenced by how psychiatric services are organized?

A transition is taking place in the organization of psychiatric services. The length of stay in hospitals is reduced and partly replaced by treatment and care in the community. The readmission rate is proposed as one indicator to analyse the effectiveness of this transition. A comprehensive literature review was conducted to ascertain whether readmission rates differ with different service systems. The search yielded 77 articles, of which 28 were selected on the basis of aims and objectives of the articles. The results show that approximately 50% of all patients admitted to psychiatric hospitals are previously admitted patients. Longer length of stay, appropriate discharge planning, and follow-up visits after discharge predicted fewer readmissions, whereas the quantity and quality of community care did not seem to have any impact on readmission rates. On the basis of the analysis of the literature review it is concluded that readmission rates are not a suitable indicator of quality of care in psychiatric hospitals. Readmission rates may, however, be an important tool in the planning of mental health services.