Research Department, Hospital Psiquiátrico "Fray Bernardino Álvarez" (HPFBA), 14080 Ciudad de Mexico, Mexico.
Graduate School of Medicine, Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de Mexico (UNAM), 54090 Estado de Mexico, Mexico.
Actas Esp Psiquiatr. 2024 Aug;52(4):405-411. doi: 10.62641/aep.v52i4.1651.
Readmission, defined as any admission after discharge from the same hospital, has negative implications for health outcomes. This study aims to identify the sociodemographic and clinical factors associated with hospital readmission among psychiatric patients.
This case-control study analyzed 202 clinical records of patients admitted to a psychiatric hospital between 2019-2021. The sample was selected using simple random sampling. Qualitative variables were presented using frequencies, percentages, and chi-square tests for association. Quantitative variables were described using central tendency measures and dispersion of data, investigated with the Kolmogorov-Smirnov test, Student's t-test or Wilcoxon test as appropriate. Regression analysis was conducted to determine factors linked to readmission. p < 0.05 was considered.
Women accounted for a higher readmission rate (59%). Patients diagnosed with schizophrenia had a higher readmission rate (63%), experienced longer transfer times to the hospital during readmissions, and had shorter hospital stays. Polypharmacy and pharmacological interactions were associated with readmission. Olanzapine treatment was identified as a risk factor for readmission (ExpB = 3.203, 95% CI 1.405-7.306, p = 0.006).
The findings suggest avoiding polypharmacy and medications with high side effect profiles to reduce readmissions. This study offers valuable insights for clinical decision-making from admission to discharge planning, aiming to enhance the quality of care.
再入院是指在同一医院出院后的再次入院，对健康结果有负面影响。本研究旨在确定与精神科患者住院再入院相关的社会人口学和临床因素。
本病例对照研究分析了 2019-2021 年间一家精神病院收治的 202 例临床病历。采用简单随机抽样法选择样本。定性变量采用频率、百分比和卡方检验进行关联分析。定量变量采用集中趋势测量和数据离散度描述，用 Kolmogorov-Smirnov 检验、学生 t 检验或威尔科克森检验进行调查。回归分析用于确定与再入院相关的因素。p < 0.05 被认为具有统计学意义。
女性的再入院率较高（59%）。被诊断为精神分裂症的患者再入院率更高（63%），在再入院期间转院到医院的时间更长，住院时间更短。药物治疗方案复杂和药物相互作用与再入院相关。奥氮平治疗被确定为再入院的危险因素（ExpB = 3.203，95%CI 1.405-7.306，p = 0.006）。
研究结果表明，避免药物治疗方案复杂和具有高副作用特征的药物可以降低再入院率。本研究为从入院到出院计划的临床决策提供了有价值的见解，旨在提高护理质量。
