Dose-response relationship between depressive symptoms and hospital readmission.
J Hosp Med
; 9(6): 358-64, 2014 Jun.
Article
em En
| MEDLINE
| ID: mdl-24604881
ABSTRACT
BACKGROUND:
Evidence suggests depression increases hospital readmission risk.OBJECTIVE:
Determine whether depressive symptoms are associated with unplanned readmission within 30 days of discharge of general medical patients.DESIGN:
Secondary analysis of the Project Re-Engineered Discharge (RED) randomized controlled trials.SETTING:
Urban academic safety-net hospital. PATIENTS A total of 1418 hospitalized adult English-speaking patients. INTERVENTION The 9-Item Patient Health Questionnaire (PHQ-9) was used to screen patients for depressive symptoms. MEASUREMENTS Hospital readmission within 30 days of discharge. Poisson regression was used to control for confounding variables.RESULTS:
There were 225 (16%) patients who screened positive for mild depressive symptoms (5 ≤PHQ-9 ≤ 9) and 336 (24%) for moderate or severe depressive symptoms (PHQ-9 ≥ 10). After controlling for confounders, a higher rate of readmission was observed in subjects with mild depressive symptoms compared to subjects with PHQ-9 <5, incidence rate ratio (IRR) 1.49 (95% confidence interval [CI] 1.11-2.00). The adjusted IRR of readmission for those with moderate-to-severe symptoms was 1.96 (95% CI 1.51-2.49) compared to those with no depression.CONCLUSIONS:
Screening positive for mild and moderate-to-severe depressive symptoms during a hospitalization on a general medical service is associated with an increased dose-dependent readmission rate within 30 days of discharge in an urban, academic, safety-net hospital. Further research is needed to determine whether treatments targeting the reduction of depressive symptoms reduce the risk of readmission.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Alta do Paciente
/
Readmissão do Paciente
/
Depressão
Tipo de estudo:
Clinical_trials
/
Diagnostic_studies
Limite:
Adult
/
Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
J Hosp Med
Ano de publicação:
2014
Tipo de documento:
Article
País de publicação:
EEUU
/
ESTADOS UNIDOS
/
ESTADOS UNIDOS DA AMERICA
/
EUA
/
UNITED STATES
/
UNITED STATES OF AMERICA
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US
/
USA