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BMC Psychiatry
Published in: BMC Psychiatry 1/2016

Open Access 01-12-2016 | Research article

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

Authors: Kyu-Tae Han, Seo Yoon Lee, Sun Jung Kim, Myung-Il Hahm, Sung-In Jang, Seung Ju Kim, Woorim Kim, Eun-Cheol Park

Published in: BMC Psychiatry | Issue 1/2016

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Abstract

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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Metadata
Title
Readmission rates of South Korean psychiatric inpatients by inpatient volumes per psychiatrist
Authors
Kyu-Tae Han
Seo Yoon Lee
Sun Jung Kim
Myung-Il Hahm
Sung-In Jang
Seung Ju Kim
Woorim Kim
Eun-Cheol Park
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2016
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/s12888-016-0804-y

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