Early and Frequent Psychiatric Readmissions in a Brazilian Cohort of Hospitalized Patients Between 2001 and 2013

Objective To characterize the profile of patients who were readmitted for mental and behavioral disorders, in the Brazilian Unified Health System, from 2001 to 2014, and the factors associated with early and frequent readmission. Method A retrospective, non-concurrent cohort study of patients admitted with a primary diagnosis of mental or behavioral disorders, from 2001 to 2014. This study selected demographic variables and clinical variables, as well as variables related to the characteristics of the hospitals. Poisson Regression methods with a robust variance estimator were used to estimate the incidence rate ratio (IRR) for each of the outcomes. Results Early readmission occurred for 6.8% of the patients and frequent readmission for 8.3%. Characteristics such as being male, younger, with a diagnosis of a bipolar disorder, and admitted to a specialized hospital show a higher IRR for early readmission. The occurrence of early readmission was the most heavily associated characteristic with an increased rate of early readmission, and the magnitude of this increase depends on the patient’s age. Conclusion Early and frequent readmissions are linked to patients’ demographics, clinical information and health system’s organization. Early readmission should be a priority in treatment planning to prevent frequent readmissions due to its strong association.