Readmission and risk factors among community rehabilitation users with psychiatric diseases

Objectives: With reference to phase I and phase II of Andersen's behavioral model of health service utilization, the aims of this study were first to investigate the characteristics of community rehabilitation care users and then to analyze the frequency of readmission and its risk factors within one year after discharge from a hospital for the treatment of mental illness. Methods: A retrospective cohort study design was used. Data analyzed in this study were retrieved from the 'home care specific files' of the National Health Insurance Research Database issued by the National Institutes of Health between 1999 and 2009. A total of 25,218 people were new cases of community rehabilitation care between 2000 and 2007. In order to forecast these community rehabilitation care users' risk of readmission within one year after discharge, the Cox proportional hazard model was utilized. Results: We found that the adjusted hazard ratio was significantly lower for groups of 8-14 times users and 15 or more-times users of community rehabilitation care than for 1-7 times users (0.73 & 0.72 respectively) in the Cox regression model. Furthermore, the risk of readmission was lower for females, clients who were insured by sub-bureau in the middle of Taiwan, a diagnosis of schizophrenia, and a length of hospital stay less than 55 days. Conclusions: The lower the frequency of psychiatric patients' using community rehabilitation care, the higher the risk of readmission. (Taiwan J Public Health. 2013;32(6):586-598).