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, Euncheol Park

Research output: Contribution to journalArticle

5 Citations (Scopus)

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.

Original languageEnglish
Article number96
JournalBMC Psychiatry
Volume16
Issue number1
DOIs
Publication statusPublished - 2016 Apr 8

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Psychiatry
Inpatients
Republic of Korea
Odds Ratio
National Health Programs
Confidence Intervals
Mood Disorders
Schizophrenia
Paranoid Schizophrenia
Multilevel Analysis
Somatoform Disorders
Neurotic Disorders
Mental Disorders
Analysis of Variance
Mental Health
Delivery of Health Care

All Science Journal Classification (ASJC) codes

  • Psychiatry and Mental health

Cite this

Han, Kyu Tae ; Lee, Seo Yoon ; Kim, Sun Jung ; Hahm, Myung Il ; Jang, Sung In ; Kim, Seung Ju ; Kim, Woorim ; Park, Euncheol. / Readmission rates of South Korean psychiatric inpatients by inpatient volumes per psychiatrist. In: BMC Psychiatry. 2016 ; Vol. 16, No. 1.
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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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Readmission rates of South Korean psychiatric inpatients by inpatient volumes per psychiatrist. / Han, Kyu Tae; Lee, Seo Yoon; Kim, Sun Jung; Hahm, Myung Il; Jang, Sung In; Kim, Seung Ju; Kim, Woorim; Park, Euncheol.

In: BMC Psychiatry, Vol. 16, No. 1, 96, 08.04.2016.

Research output: Contribution to journalArticle

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T1 - Readmission rates of South Korean psychiatric inpatients by inpatient volumes per psychiatrist

AU - Han, Kyu Tae

AU - Lee, Seo Yoon

AU - Kim, Sun Jung

AU - Hahm, Myung Il

AU - Jang, Sung In

AU - Kim, Seung Ju

AU - Kim, Woorim

AU - Park, Euncheol

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N2 - 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.

AB - 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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