Readmission of adolescent psychiatric patients to a specialised unit in Gauteng, South Africa

Abstract

BACKGROUND : Readmission rates to child and adolescent psychiatric units among the youth have been reported to be increasing. AIM : The study aimed to determine the readmission rate and factors associated with readmission of adolescent psychiatric patients at a child and adolescent psychiatric unit. SETTING : A specialised psychiatric hospital in Gauteng province, South Africa. METHODS : This retrospective cohort study utilised data from the records of patients admitted to the adolescent inpatient unit over a period of five years. The cumulative incidence and incidence rate of readmission within one year of discharge from the index admission was calculated using survival analysis methods. Characteristics significantly associated with readmission were determined by applying the multivariable Cox proportional hazards regression model. RESULTS : Among the 189 patients included in the analysis, the cumulative incidence of readmission within one year of discharge was 17.5%. The incidence rate was 5.31 readmissions per 10 000 person-days. The final multivariable model showed that a diagnosis of schizophrenia (p = 0.015), a diagnosis of attention deficit hyperactivity disorder (p = 0.039), and coming from a child and youth care centre or temporary safe care (p = 0.018) increased the risk of readmission while having a medical condition (p = 0.008) reduced the risk. CONCLUSION : Psychiatric diagnosis and residential care could be potential risk markers for readmission. Improving the collaboration between health and social services in residential care would be beneficial. CONTRIBUTION : Identifying factors that predispose adolescent psychiatric patients to readmission can inform and improve management and risk assessments.