Short-term clinical outcomes of psychiatric patients Admitted to psychiatry wards of selected hospitals in Ethiopia: a prospective observational study

Abstract

Background: Psychiatric early readmission is a common and unfavorable outcome for both individual patients and the healthcare system and it is regarded as a useful indicator to measure quality of care provided by hospitals worldwide. In Ethiopia a few data are available regarding short term clinical outcomes of psychiatric patients in general early readmission in particular. Objective: To determine short-term clinical outcomes among adult psychiatric patients admitted to psychiatry wards of Jimma medical center and St. Amanuel mental specialized hospital, Ethiopia. Methods: A prospective observational study was conducted involving 278 adult psychiatry patients admitted to psychiatry ward of Jimma medical center and St. Amanuel mental specialized hospital during a 7 months study period from December 2021 to June 2022. Data was analyzed using STATA V.16. Descriptive analysis was used to present patient’s characteristics. Logistic regression was conducted to identify factors associated with discharge outcome, while cox-regression analysis was employed to determine the independent predictors of early- readmission. In all the analysis, p value <0.05 was used to declare statistical significance. Result: A total of 29 (10.43%) of the patients showed improved outcomes on discharge. Khat use (AOR= 3.59, 95% CI = 1.21-10.65) independently predicted unimproved discharge outcome. Forty seven (16.91%) patients were readmitted within 90-days after discharge. Patients’ monthly income (AHR = 0.99, 95% CI = 0.99-0.991), poor social support (AHR = 12.96, 95% CI = 2.59- 64.83), non-adherence to medications (AHR = 5.74, 95% CI = 2.01–16.41) and unimproved symptoms of patients upon discharge (AHR = 8.26, 95% CI = 2.30-29.72) were independently predicted readmission status overtime. Conclusion and recommendation: Most participants were discharged after improvement, and significant risk of discharge without improvement has been noted in Khat users. After discharge, one in six patients was readmitted within three months. The risk of readmission had increased in those with poor social support status, medication non-adherence, and discharge without improvement. Interventions targeted at the identified risk factors are recommended by the concerned stakeholders to improve the outcomes of patients with psychiatric disorders.