(Nov. 7, 2017) Schizophrenia is the leading cause of hospital readmissions to community hospitals in the United States, according to a new government brief.
More than 9% of the 374,097 hospitalizations for schizophrenia and other psychotic disorders resulted in a readmission to the same hospital within 7 days of discharge in 2014. Almost 23% of those, or 85,668 hospitalizations, resulted in a readmission within 30 days of discharge.
The brief is developed by the Healthcare Cost and Utilization Project, a collection of hospital databases developed for the federal government. This includes the Nationwide Readmissions Database, a database that includes community hospitals in the United States.
Schizophrenia is leading cause of rehospitalization across payers
Researchers also examined rehospitalization rates by different insurance payers. Schizophrenia was the leading cause of readmission within 7 days of discharge for both public insurances, Medicaid and Medicare, and for individuals uninsured. Among private insurers, schizophrenia and other psychotic disorders were among the top three leading cause of hospital readmissions, behind renal failure and ulcerative colitis.
As reported in a November 2016 Office of Research and Public Affairs report, Released, Relapsed, Rehospitalized, high hospital readmission rates among individuals with serious mental illness are in part due to the psychiatric bed shortage and resulting shortening of length of stay in a hospital bed. "Releasing patients faster creates more bed capacity without requiring new beds," Doris Fuller, the author of the study writes. "Unsurprisingly, given widespread psychiatric bed shortages and pressure on hospitals to reduce hospitalization costs, length of stay has been shrinking for decades."
However, rehospitalization is also costly. Inpatient hospitalization is the single greatest direct cost along the continuum of care for individuals with serious mental illness. Of the $11.4 billion spent on schizophrenia hospitalization in 2014, $1.1 billion resulted from readmission within 30 days of discharge.
Elizabeth Sinclair
Research Associate
References:
- Fingar, K.R. et al. (October 2017). A comparison of all-cause 7-day and 30-day readmissions, 2014. Healthcare Cost and Utilization Project.
- Healthcare Cost and Utilization Project. (2017). All patient readmissions #659 Schizophrenia and other psychotic disorders. HCUPnet.