Predictors of Rehospitalization in High-Utilizing Patients
in the VA Psychiatric Medical System
Nicholas W. Bowersox
Stephen M. Saunders
Bertrand D. Berger
Published online: 24 June 2011
Ó Springer Science+Business Media, LLC (outside the USA) 2011
Abstract 233 high-service-utilizing (HSU) psychiatric patients were recruited during an
inpatient psychiatric treatment. They completed a questionnaire related to their treatment
beliefs and were tracked via computerized medical records over 2 years. During the fol-
low-up period, 79.8% were readmitted for additional inpatient psychiatric treatment.
Survival analysis techniques were used to examine patients’ rates of readmittance during
the follow-up period. Number of previous year inpatient psychiatric days served as a
signiﬁcant predictor of readmittance status and time to readmission. The survival plot was
split by previous-year inpatient days to examine the effect of this variable on readmission.
Implications of ﬁndings are discussed.
Keywords High-utilizing psychiatric patients Á Rehospitalization Á Survival analysis Á
Theory of planned behavior
A subset of psychiatric patients accounts for a sizable proportion of emergency psychiatric
service use. These patients are characterized by multiple inpatient psychiatric admissions,
limited engagement in outpatient psychiatric care, and increased level of disability [1, 2].
N. W. Bowersox (&)
Department of Veterans Affairs, Health Services Research and Development, Serious Mental Illness
Treatment Research and Evaluation Center (SMITREC), PO Box 130170, Ann Arbor,
MI 48113-0170, USA
S. M. Saunders
Marquette University, Milwaukee, WI, USA
B. D. Berger
Milwuakee VA Hospital, Milwaukee, WI, USA
B. D. Berger
Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin,
Milwaukee, WI, USA
Psychiatr Q (2012) 83:53–64