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Readmission rates of South Korean psychiatric inpatients by inpatient volumes per psychiatrist.

 Kyu-Tae Han  ;  Seo Yoon Lee  ;  Sun Jung Kim  ;  Myung-Il Hahm  ;  Sung-In Jang  ;  Seung Ju Kim  ;  Woorim Kim  ;  Eun-Cheol Park 
 BMC Psychology, Vol.16(96) : 96, 2016 
Journal Title
 BMC Psychology 
Issue Date
Adult ; Aged ; Female ; Humans ; Inpatients/psychology* ; Inpatients/statistics & numerical data* ; Male ; Mental Disorders/epidemiology* ; Mental Disorders/therapy* ; Middle Aged ; Odds Ratio ; Patient Readmission/statistics & numerical data* ; Psychiatry/statistics & numerical data* ; Republic of Korea ; Risk
Patient volume ; Psychiatric care ; Quality of care ; Readmission
BACKGROUND: Readmission rates of psychiatric inpatients are higher in South Korea than other Organization for Economic Co-operation and Development (OECD) countries. In addition, the solution for readmission control is deficient based on the characteristics of the South Korean National Health Insurance (NHI) system. Therefore, it is necessary to identify ways to reduce psychiatric inpatient readmissions. This study investigated the relationship between inpatient volume per psychiatrist and the readmission rate of psychiatric inpatients in South Korea. METHOD: We used NHI claim data (N = 37,796) from 53 hospitals to analyze readmission within 30 days for five diagnosis (organic mental disorders, mental and behavioral disorders due to psychoactive substance use, schizophrenia, mood disorders, neurotic disorders, and stress-related and somatoform disorders) between 2010 and 2013. We performed χ2 and analysis of variance tests to investigate associations between patient and hospital-level variables and readmission within 30 days. Finally, generalized estimating equation (GEE) models were analyzed to examine possible associations with readmission. RESULTS: Readmissions within 30 days accounted for 1,598 (4.5 %) claims. Multilevel analysis demonstrated that inpatient volume per psychiatrist were inversely related with readmission within 30 days (low odds ratio [OR]: 0.38, 95 % confidence interval [CI]: 0.28-0.51; mid-low OR: 0.48, 95 % CI: 0.36-0.63; mid-high OR: 0.55, 95 % CI: 0.44-0.69; Q4 = ref). The subgroup analysis by diagnosis revealed that both "schizophrenia, schizotypal, and delusional disorders" and "mood disorders" had inverse relationships with readmission risk for all volume groups. CONCLUSIONS: We observed an inverse association between inpatient volume per psychiatrist and the 30-day readmission rate of psychiatric inpatients, suggesting that it could be a useful quality indicator in mental health care.
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1. College of Medicine (의과대학) > Dept. of Preventive Medicine and Public Health (예방의학교실) > 1. Journal Papers
Yonsei Authors
Park, Eun-Cheol(박은철) ORCID logo https://orcid.org/0000-0002-2306-5398
Jang, Sung In(장성인) ORCID logo https://orcid.org/0000-0002-0760-2878
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