Symptom, family, and service predictors of children's psychiatric rehospitalization within one year of discharge

Research output: Contribution to journalArticle

88 Scopus citations

Abstract

Objective: To investigate predictors of readmission to inpatient psychiatric treatment for children aged 5 to 12 discharged from acute-care hospitalization. Method: One hundred nine children were followed for 1 year after discharge from inpatient care. Time to rehospitalization was the outcome of interest. Predictors of readmission, examined via the Cox proportional hazards model, were symptom and family factors assessed at admission, aspects of psychiatric treatment, and demographic variables. Results: The Kaplan-Meier rehospitalization risk within 1 year of discharge, taking into account known readmissions and censored observations, was 0.37. Most readmissions (81%) occurred within 90 days of discharge. Four variables contributed simultaneously to predicting readmission risk, More severe conduct problems, harsh parental discipline, and disengaged parent-child relations conferred a higher risk for rehospitalization; these risks were attenuated when parents disclosed higher stress in their parenting roles. Conclusions: Findings showed that psychiatric rehospitalization of children is common, most likely in the trimester after discharge, and highly related to both child symptoms and family factors measurable at admission. Results suggest that efforts to improve postdischarge outcomes of children should target the initial period following inpatient care, address vigorously the complex treatment needs of those with severe conduct problems, and aim to improve parent-child relations.

Original languageEnglish (US)
Pages (from-to)440-451
Number of pages12
JournalJournal of the American Academy of Child and Adolescent Psychiatry
Volume43
Issue number4
DOIs
StatePublished - Apr 2004
Externally publishedYes

Keywords

  • Behavior disorder
  • Family processes
  • Hospitalization
  • Psychiatric services

ASJC Scopus subject areas

  • Developmental and Educational Psychology
  • Psychiatry and Mental health

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