Six-month readmission and associated factors among psychiatry patients at Moi Teaching and Referral Hospital, Western Kenya

Abstract

Background Hospital readmissions due to mental illnesses increase the burden and costs of patient management globally. While the transition to community-based mental health care is a key focus, readmission rates remain high. Understanding the risk factors associated with readmission to mental health units can help healthcare workers implement effective measures to reduce readmissions, enhance patient outcomes, and strengthen community-based care. Objectives To determine readmission rates among psychiatric patients at Moi Teaching and Referral Hospital (MTRH) and the socio-demographic and clinical factors associated with readmission. Methods The study was a prospective cohort study. The study was conducted at the Mental Health Unit of Moi Teaching and Referral Hospital. A calculated sample of 219 participants was recruited at discharge from the mental health ward and followed up for a period of six months. Consent to recruit participants was obtained after either administration of the University of California San Diego Brief Assessment Capacity to Consent tool to them or collaborative history from their caretakers. An interviewer-administered questionnaire was used to collect information on socio-demographic and clinical characteristics of the participants. They were followed up for six months to check for readmission. Data entry and cleaning was done using Microsoft Access and data analyzed using both descriptive and inferential statistical methods. Results The median age of participants was 34, with most (67%) being male. Nearly half (48.9%) were single, while 34.7% were married. A majority (71.6%) had secondary or lower education. Almost half (44.7%) were unemployed, another 44.7% had temporary jobs. Over half (54.6%) lacked health insurance. Most (93.6%) were admitted involuntarily. The most common diagnoses were substance use disorder (32.4%), schizophrenia (25.1%) and bipolar disorder (24.2%). Over half (54.3%) missed medication before admission, 15.5% had suicide history, and 56.6% had a history of violence. The 6-month readmission rate was 30.6%. Logistic regression analysis showed that, those with health insurance were 3.13 times most likely to be readmitted (aOR=3.13, p=0.03), those with bipolar mood disorder were 3.85 times more likely to be readmitted (aOR 3.85, 95% CI 1.20, 12.50)) and those with primary level of education were 2.63 times more likely to be readmitted (aOR 2.63, 95% CI 1.10, 6.67).