Although patients with serious mental illness (SMI) and other chronic illnesses are considered a high-risk group, a new study found that patients with SMI and diabetes were not more likely than other patients to be readmitted to the hospital a month after discharge.
The researchers examined 26,878 admissions of patients with diabetes to a large urban hospital. Of patients with SMI age 35 or younger, SMI was significantly associated with decreased odds of 30-day hospital readmission. Male sex, having more than 3 coexisting illnesses, and a hospital stay longer than 4 days were all significant predictors of 30-day readmission. Older age was associated with a greater likelihood of readmission, but this was not statistically significant. Among patients with diabetes and SMI older than 35, SMI was not significantly associated with readmission.
One explanation may be that individuals with SMI die, on average, 25 years earlier than people who do not have SMI. Thus older patients with SMI with a greater risk of hospital readmission may have died already. Another reason is that those patients old enough to be on Medicare may visit a primary care physician rather than returning to the hospital for care.
The prevalence of SMI in the study population was 6 percent. Patients with SMI differed significantly from those without SMI. They were more likely to be female, younger, to have a lower mean number of coexisting illnesses, and to have spent more time in the hospital during their initial hospital admission. This study was supported by AHRQ (HS21068, HS18111).
For further details, see "Serious mental illness and acute hospital readmission in diabetic patients," by Jennifer S. Albrecht, B.A., Jon Mark Hirshon, M.D., M.P.H., Ph.D., Richard Goldberg, Ph.D., and others in the American Journal of Medical Quality 27, pp. 503-508, 2012.