The purpose of this investigation was to investigate how often psychiatric patients changed diagnosis on readmission to hospitals. On the basis of the most recent discharge diagnosis it was registered how many patients who had been diagnosed in other major diagnostic groups over a 10-year period, and a mobility of 40.6% was found. By comparison with other investigations it was shown, that the changes most often took place in the first two years. The mobility was most marked for the neurosis-group and was approximately uniform for the other groups.
Unscheduled return visits to the emergency department (ED) represent a considerable segment of older adults' total visits to the ED. This study explores the factors that led to early return visits to the ED by older adults. Using a qualitative descriptive design, semi-structured interviews were conducted in a large teaching hospital with 15 older adults who returned to the ED within 2 weeks after an initial visit. From the interviews, three major themes emerged as precipitants that led older adults to return to the ED. These were Managing the Symptoms, Care Curing the Initial ED Visit, and Who I Am. The findings suggest that the main reason for older adults' return to the ED is the severity of the symptoms they experienced. Ensuring the timeliness of follow-up appointments and the provision of resources to support the transition home are identified as interventions that would improve the care provided in EDs.
Community adjustment of former psychiatric patients has been found to relate highly to the likelihood of rehospitalization and community tenure. The present study examined the ability of a community adjustment scale and various other patient characteristics to predict rehospitalization. Multiple regression analysis using rehospitalization as the dependent variable identified thirteen items including twelve from the community adjustment scale, which combined to provide a highly accurate prediction. The brief scale (13 items) which is now being cross-validated is potentially a useful tool for clinical evaluation and planning of follow-up series to former patients.
The aim of the present study was to produce a nation-wide quantitative description of re-admissions for schizophrenia in Denmark in the period 1979-1998. The study is based on anonymous data from the Psychiatric Central Register. All persons with a main diagnosis of schizophrenia are included. The number of re-admissions of schizophrenics has constantly increased since 1979 (approx. 65%), and the number of persons who account for these re-admissions has increased by approximately 55%. Patients who for the first time are diagnosed with schizophrenia have in the first year after the first admission an average risk of re-admission of 50%, a risk that has not decreased during the 20 years studied. The median age of re-admitted patients has increased by five years for males and is almost unchanged for females indicating a continuous need for re-admission of schizophrenic patients, also the older patients. Danish psychiatry has each year contact with approximately 50% of the persons who at least once have been diagnosed with schizophrenia since 1969 and who are still alive. Certain precautions must be taken in the interpretations of general aggregated statistics such as these.