Hospital Readmission Among Medicaid Patients with an Index Hospitalization for Mental and/or Substance Use Disorder
Hospital Readmission Among Medicaid Patients with an Index Hospitalization for Mental and/or Substance Use Disorder
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DOI：
10.1007/s11414-013-9323-5
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发表时间：
2013-04-01
影响因子：
1.9
通讯作者：
Smith, Shelagh
中科院分区：
文献类型：
--
作者：
Mark, Tami;Tomic, Karen Smoyer;Smith, Shelagh
医院再入院率越来越多地被用作一项绩效指标。他们是否是一个有效的，可靠的，可操作的措施行为健康是未知的。使用MarketScan多州医疗补助索赔数据库，本研究检查了行为健康再入院率的医院和患者水平预测因素。在每年至少有25名住院患者的医院中，行为健康再入院率的中位数为11%（第10百分位数，3%;第90百分位数，18%）。在社区精神卫生中心增加随访与再入院概率降低相关，尽管与其他类型的提供者进行随访与再入院无显著相关性。平均住院时间与较低的再入院率呈正相关;然而，影响量很小。有住院史、物质使用障碍、精神病和内科合并症的患者更有可能再次入院。需要进一步研究以进一步了解提供住院服务和出院后随访如何影响再入院。
Hospital readmission rates are increasingly used as a performance indicator. Whether they are a valid, reliable, and actionable measure for behavioral health is unknown. Using the MarketScan Multistate Medicaid Claims Database, this study examined hospital- and patient-level predictors of behavioral health readmission rates. Among hospitals with at least 25 annual admissions, the median behavioral health readmission rate was 11% (10th percentile, 3%; 90th percentile, 18%). Increased follow-up at community mental health centers was associated with lower probabilities of readmission, although follow-up with other types of providers was not significantly associated with hospital readmissions. Hospital average length of stay was positively associated with lower readmission rates; however, the effect size was small. Patients with a prior inpatient stay, a substance use disorder, psychotic illness, and medical comorbidities were more likely to be readmitted. Additional research is needed to further understand how the provision of inpatient services and post-discharge follow-up influence readmissions.