The revolving door phenomenon revisited: time to readmission in 17’145 [corrected] patients with 37'697 hospitalisations at a German psychiatric hospital.

<h4>Objective</h4>Despite the recurring nature of the disease process in many psychiatric patients, individual careers and time to readmission rarely have been analysed by statistical models that incorporate sequence and velocity of recurrent hospitalisations. This study aims at comparin...

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Autores principales:	Ulrich Frick, Hannah Frick, Berthold Langguth, Michael Landgrebe, Bettina Hübner-Liebermann, Göran Hajak
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2013
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/2efb94691c7d4db8b98d55c69c5fdc00
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spelling	oai:doaj.org-article:2efb94691c7d4db8b98d55c69c5fdc002021-11-18T08:51:58ZThe revolving door phenomenon revisited: time to readmission in 17’145 [corrected] patients with 37'697 hospitalisations at a German psychiatric hospital.1932-620310.1371/journal.pone.0075612https://doaj.org/article/2efb94691c7d4db8b98d55c69c5fdc002013-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/24116059/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Objective</h4>Despite the recurring nature of the disease process in many psychiatric patients, individual careers and time to readmission rarely have been analysed by statistical models that incorporate sequence and velocity of recurrent hospitalisations. This study aims at comparing four statistical models specifically designed for recurrent event history analysis and evaluating the potential impact of predictor variables from different sources (patient, treatment process, social environment).<h4>Method</h4>The so called Andersen-Gil counting process model, two variants of the conditional models of Prentice, Williams, and Peterson (gap time model, conditional probability model), and the so called frailty model were applied to a dataset of 17’145 [corrected] patients observed during a 12 years period starting from 1996 and leading to 37’697 psychiatric hospitalisations Potential prognostic factors stem from a standardized patient documentation form.<h4>Results</h4>Estimated regression coefficients over different models were highly similar, but the frailty model best represented the sequentiality of individual treatment careers and differing velocities of disease progression. It also avoided otherwise likely misinterpretations of the impact of gender, partnership, historical time and length of stay. A widespread notion of psychiatric diseases as inevitably chronic and worsening could be rejected. Time in community was found to increase over historical time for all patients. Most important protective factors beyond diagnosis were employment, partnership, and sheltered living situation. Risky conditions were urban living and a concurrent substance use disorder.<h4>Conclusion</h4>Prognostic factors for course of diseases should be determined only by statistical models capable of adequately incorporating the recurrent nature of psychiatric illnesses.Ulrich FrickHannah FrickBerthold LangguthMichael LandgrebeBettina Hübner-LiebermannGöran HajakPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 8, Iss 10, p e75612 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Ulrich Frick Hannah Frick Berthold Langguth Michael Landgrebe Bettina Hübner-Liebermann Göran Hajak The revolving door phenomenon revisited: time to readmission in 17’145 [corrected] patients with 37'697 hospitalisations at a German psychiatric hospital.
description	<h4>Objective</h4>Despite the recurring nature of the disease process in many psychiatric patients, individual careers and time to readmission rarely have been analysed by statistical models that incorporate sequence and velocity of recurrent hospitalisations. This study aims at comparing four statistical models specifically designed for recurrent event history analysis and evaluating the potential impact of predictor variables from different sources (patient, treatment process, social environment).<h4>Method</h4>The so called Andersen-Gil counting process model, two variants of the conditional models of Prentice, Williams, and Peterson (gap time model, conditional probability model), and the so called frailty model were applied to a dataset of 17’145 [corrected] patients observed during a 12 years period starting from 1996 and leading to 37’697 psychiatric hospitalisations Potential prognostic factors stem from a standardized patient documentation form.<h4>Results</h4>Estimated regression coefficients over different models were highly similar, but the frailty model best represented the sequentiality of individual treatment careers and differing velocities of disease progression. It also avoided otherwise likely misinterpretations of the impact of gender, partnership, historical time and length of stay. A widespread notion of psychiatric diseases as inevitably chronic and worsening could be rejected. Time in community was found to increase over historical time for all patients. Most important protective factors beyond diagnosis were employment, partnership, and sheltered living situation. Risky conditions were urban living and a concurrent substance use disorder.<h4>Conclusion</h4>Prognostic factors for course of diseases should be determined only by statistical models capable of adequately incorporating the recurrent nature of psychiatric illnesses.
format	article
author	Ulrich Frick Hannah Frick Berthold Langguth Michael Landgrebe Bettina Hübner-Liebermann Göran Hajak
author_facet	Ulrich Frick Hannah Frick Berthold Langguth Michael Landgrebe Bettina Hübner-Liebermann Göran Hajak
author_sort	Ulrich Frick
title	The revolving door phenomenon revisited: time to readmission in 17’145 [corrected] patients with 37'697 hospitalisations at a German psychiatric hospital.
title_short	The revolving door phenomenon revisited: time to readmission in 17’145 [corrected] patients with 37'697 hospitalisations at a German psychiatric hospital.
title_full	The revolving door phenomenon revisited: time to readmission in 17’145 [corrected] patients with 37'697 hospitalisations at a German psychiatric hospital.
title_fullStr	The revolving door phenomenon revisited: time to readmission in 17’145 [corrected] patients with 37'697 hospitalisations at a German psychiatric hospital.
title_full_unstemmed	The revolving door phenomenon revisited: time to readmission in 17’145 [corrected] patients with 37'697 hospitalisations at a German psychiatric hospital.
title_sort	revolving door phenomenon revisited: time to readmission in 17’145 [corrected] patients with 37'697 hospitalisations at a german psychiatric hospital.
publisher	Public Library of Science (PLoS)
publishDate	2013
url	https://doaj.org/article/2efb94691c7d4db8b98d55c69c5fdc00
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The revolving door phenomenon revisited: time to readmission in 17’145 [corrected] patients with 37'697 hospitalisations at a German psychiatric hospital.

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