Psychiatric illness may contribute to higher 30-day hospital readmission rates for patients with heart failure (HF), acute myocardial infarction (AMI), and pneumonia, according to a study of 160,169 patients served by 11 U.S. health systems.
From 2009 to 2011, about 21.7% of patients with psychiatric comorbidity went back to the hospital within 30 days of discharge, compared with 15.5% of those without such diagnoses, said Brian Ahmedany, Ph.D., L.M.S.W., of the Center for Health Policy and Health Services Research at the Henry Ford Health System in Detroit and colleagues in Psychiatric Services in Advance yesterday.
“Individuals with comorbid anxiety, dementia, and depression had higher rates of readmission than persons with no psychiatric comorbidity regardless of whether the index hospitalization was for HF, AMI, or pneumonia,” the researchers found. “[H]ealth systems should consider adding elements of mental health assessment, diagnosis, monitoring, and treatment to interventions to prevent 30-day all-cause hospital readmissions.”
Those elements might include psychiatric screening and evaluation, discharge planning that includes a mental health component, and follow-up for psychiatric conditions that includes outpatient treatment.
Ahmedany and colleagues noted that the gap in readmission rates between patients with and without psychiatric comorbidities shrank from 6.0% in 2009 to 4.1% in 2011. That was an encouraging trend but might be narrowed still further by adoption of interventions specifically designed for these conditions.
For more on the interface between psychiatric and general medical conditions, see the American Psychiatric Publishing book, Integrated Care: Working at the Interface of Primary Care and Behavioral Health, edited by Lori Raney, M.D.
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