Identifying Modifiable Risk Factors for Rehospitalization

A Case-Control Study of Seriously Mentally Ill Persons in Mississippi

Published In: American Journal of Psychiatry, v. 152, no. 12, Dec. 1, 1995, p. 1749-1756

Posted on RAND.org on December 31, 1994

by Greer Sullivan, Kenneth B. Wells, Hal Morgenstern, Barbara Leake

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The authors used a case-control design to identify risk factors for rehospitalization in a seriously mentally ill population in rural Mississippi. The study focused on factors that have the potential for modification through community-based interventions. Most of the patients had schizophrenia, and all had been hospitalized at least once for a serious mental condition. Data were collected from structured interviews of subjects and informants (mostly family members), as well as direct observation. The study found that medication noncompliance, comorbid alcohol abuse, and a high level of criticism from informants were associated with greater risk for rehospitalization, while risk factors traditionally used in medical research use of outpatient services, access to care, quality of life, and some demographic variables (including ethnicity and gender)--were not. The findings imply that interventions targeted at improving medication compliance, reducing alcohol abuse, and helping families cope with the mentally ill could reduce the risk of rehospitalization in this population.

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