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Predictors of Cost and Incidence of 30-Day Readmissions Following Hospitalizations for Schizophrenia and Psychotic Disorders

A Nationwide Analysis

Wani, Rajvi J. PhD, MS; Kathe, Niranjan J. PhD, MS; Klepser, Donald G. PhD, MBA

doi: 10.1097/QMH.0000000000000223
Original Research

Background: Schizophrenia and psychotic disorders (SPDs)-related hospitalizations are the second leading cause of 30-day readmission. This study assessed the effect of patient and hospital-level factors on readmission costs following index hospital discharges for SPDs.

Methods: 2014 Nationwide Readmissions Database was used to identify SPD-related discharges between January 1, 2014, and November 30, 2014. Multivariable logistic regression was used to estimate patient and hospital-level predictors for readmissions. A two part model was used to estimate the predictors of readmission and associated cost for index hospital discharges with SPDs.

Results: A total of 77 625 of 343 579 (22%) index hospital discharges for SPDs resulted in readmissions. The average index and readmission costs were $9285 and $8593, respectively. Being 25 to 44 years old (odds ratio: 1.14), with nonmental comorbidities (odds ratio: 1.52), and admitted in private hospitals (odds ratio: 1.24) had significantly higher odds of readmission rates. Being males ($105), 25 to 44 years of age ($99), urban residents ($312), Medicare enrollees ($713 over privately insured), high-income area residents ($393), having multiple comorbidities ($923), and those admitted in large metropolitan ($680) and government-owned hospitals ($417) had higher costs of readmission.

Conclusion: The high SPD-related readmission rates can be reduced by providing integrated behavioral health services for this high-risk cohort.

College of Education and Human Sciences, University of Nebraska-Lincoln (Dr Wani); Division of Pharmaceutical Evaluation and Policy, Department of Pharmacy Practice, University of Arkansas for Medical Sciences, College of Pharmacy, Little Rock (Dr Kathe); and Department of Pharmacy Practice and Science, College of Pharmacy, University of Nebraska Medical Center, Omaha (Dr Klepser).

Correspondence: Rajvi J. Wani, PhD, MS, 688 W. Hastings street, Suite 450, Vancouver, BC, V6B 1P1, Canada (

The authors have no direct or indirect financial incentives associated with the conduct of the study or publication of study findings.

© 2019Wolters Kluwer Health | Lippincott Williams & Wilkins