Table 1 Summary table of general characteristics and results from studies included in a systematic literature review on psychiatric readmissions and their association with physical comorbidity
N of studies | Comments | |
|---|---|---|
Publication date | 1991 - 1999: 6 2000–2009: 11 2010–2013: 6 | 4 studies: 2011 2 studies/year: 2009, 2006, 2000,1997 1 study in all other years |
Country | USA: 14 Canada: 2 Denmark: 2 Australia: 2 UK: 1 Spain: 1 Japan: 1 | 61% of included studies were carried out in USA |
Source of data | Hospital medical records only: 10 Big administrative database (National registries): 7 Hospital medical records + Interviews and/or Self- assessment questionnaires, Clinical assessment instruments: 6 | 44% of included studies used data from hospital medical records |
Applied statistical method /model | Only descriptive statistics / nonparametric test: 4 Bivariate / Multivariate statistical analysis: 19 | 83% of included studies applied Bivariate / Multivariate statistical analyses |
Study population according to age | Age range: 18 – 80+ Studies focusing on elderly population: 5 | 22% of included studies focused on elderly population |
Study population according to gender | Both: 21 Only female: 1 Only man: 1 | In 2 studies with veterans were included males or females only, recruited from Veterans hospital |
Categories of psychiatric diagnoses included in the study (as index disease) | Affective disorders: 7 Substances use disorders: 7 All psychiatric diagnoses: 6 Serious mental illness: 3 | 30,5% of studies recruited patients with affective and substances use disorders; 26% with all psychiatric diagnoses; 13% with serious mental illness Affective disorders include: depression, bipolar disorder Serious mental illness include: schizophrenia, schizoaffective disorder, bipolar disorder, personality disorders |
Types of physical comorbidity variables included in studies | Specified physical comorbidity (with ICD codes): 6 Specified physical comorbidity (without ICD codes): 6 Charlson Comorbidity Index : 5 Not specified physical comorbidity: 5 Number of medical diagnoses and somatic complaints: 3 | In 2 studies were applied two types of physical comorbidity variables within the same study protocol: Charlson Comorbidity Index + Specified physical comorbidity (with ICD codes) / Specified physical comorbidity (without ICD codes) |
Most common physical comorbidity variables documented at admission/discharge in the category ”Affective disorders ” | Medical diagnoses/illness: Medical illness (not specified), Diabetes, Hyperthyroidism, Obesity, Cardiovascular disease, Hypertension, High cholesterol Variables describing the burden of medical illness: Somatic complaints (excessive concern with body or functional capacity), The number of medical diagnoses, Charlson Comorbidity Index | |
Most common physical comorbidity variables documented at admission/discharge in the category “Substances use disorders ” | Medical diagnoses/illness: Chronic lung conditions, Asthma, Hepatitis C virus (HCV) infection, Hepatitis B,HIV(+), Epilepsy, Hypothyroidism, Hypertension, Skin and subcutaneous tissue diseases, Infectious parasitic diseases, Digestive diseases, Cardiac problems/angina, Cirrhosis, Gastritis, Diabetes, Pregnancy, Accidental poisonings, Adverse drug reactions, Accidental falls Variables describing the burden of medical illness: Physical health problems, Charlson Comorbidity Index, Number of medical diagnosis | |
Most common physical comorbid variables documented at admission/discharge in the category “All psychiatric diagnoses ” | Medical diagnoses/illness: Cellulitis, Chronic obstructive pulmonary disease, Liver disease, Diabetes, Hypertension, Circulatory heart conditions, Epilepsy, Hypothyroidism Variables describing the burden of medical illness: Charlson Comorbidity Index, Number of medical diagnoses | |
Most common physical comorbidity variables documented at admission/discharge in the category “Serious mental illness ” | Variables describing the burden of medical illness: Non specified physical health problems, Charlson Comorbidity Index | None of reviewed studies in the category “Serious mental illness“did document medical diagnoses/illness |
Data on mortality | NO: 19 YES: 4 | 83% studies did not analyse mortality |
Readmission time | 12 months: 5 1 month: 3 6 months: 2 3 months: 2 24 months: 2 26 months: 2 48 months: 2 | Other less frequently used time frames for readmission time: less than 1 month (8–30 days), 58 months, 70 months, 79 months, 84 months, 192 months, 216 months, 240 months |
The impact of physical comorbidity variables on readmission | YES: 12 NO: 4 NA: 7 | 52% of included studies did show that physical comorbidity may be associated with hospital readmission 6 studies documented physical comorbidity only at admission/discharge without including them at readmission |
Most common physical comorbidity variables with higher probability for readmission according to categories of psychiatric diagnoses | Affective disorders: Not specified medical illness, Somatic complaints, Number of medical diagnoses, Hyperthyroidism Substances use disorders: Chronic lung conditions, Hepatitis C virus (HCV) infection, Hypertension, Number of medical diagnoses All psychiatric diagnoses: Cellulitis, Chronic obstructive pulmonary disease, Liver disease, Diabetes, Hypertension, Circulatory heart conditions Serious mental illness: Higher Charlson Comorbidity Index, Somatic complaints, Physical health problems | |
Applied concept of comorbidity construct | Multimorbidity: 11 Patient’s complexity: 7 Morbidity burden: 4 Comorbidity: 1 | Applied concept of comorbidity construct according to categories of psychiatric diagnoses: Affective disorders: Morbidity burden N = 3; Multimorbidity N = 2; Patient’s complexity N = 1; Comorbidity N = 1 Substances use disorders: Multimorbidity N = 6; Patient’s complexity N = 1 All psychiatric diagnoses: Patient’s complexity N = 4; Multimorbidity N = 2 Serious mental illness: Multimorbidity N = 1; Patient’s complexity N = 1; Morbidity burden N = 1 |