@article{ArjolLópez:111865,
author = "Arjol López, Elena and Campos Ródenas, Ricardo",
title = "{Perfil clínico-epidemiológico de los reingresos en la
Unidad de Hospitalización de Adultos del Hospital Clínico
Universitario Lozano Blesa. Fenómeno de la Puerta
Giratoria en Psiquiatría.}",
year = "2018",
note = "INTRODUCTION: In relation to the process of
deinstitutionalization that concerns psychiatric patients,
it came up a considerable amount of readmissions and the
term “Revolving Door”, which describes a pattern of
frequent short-term hospital readmissions to Adult
Psychiatric Unit. This entails that this type of patients
contribute a disproportional share of the total health
resources. OBJECTIVE: The aim is to investigate
sociodemographic, clinic and follow-up characteristics of
these frequent short-term hospital readmissions at the APU
of the HCULB and in relation to admissions in 2017, as well
as to compare the results with previous studies in this
health area and among others. METHODS: It is an
observational retrospective descriptive cross-sectional
design in which 395 Medical Discharged Summaries of the
Adult Psychiatric Unit of HCULB of 2017 were reviewed.
Previously, a systematic bibliographic review was done. In
those patients with frequent readmissions, their
sociodemographic, clinical and follow-up profile and
results were analysed and compared to results obtained in
previous studies. RESULTS: From the 395 Discharged
Summaries reviewed, 58 (14,7%) had two or more readmissions
in 2017 and 24 (6,1%) had three or more and were
categorized as Revolving Door. Epidemiologically, it is
observed that the phenomenon is more frequent in Spanish
patients, inactive at work, with an average of 45,4 years
and a range of 0 - 15 days. The most frequent reason for
admission is suicidal attempt. Patients who were more often
readmitted were diagnosed of personality disorders and had
an ambulatory follow-up care, with treatment failure. It
will be necessary to analyze these data in the future with
a control group, in order to measure further the strenght
of association and address specifically the cases.
C0NCLUSIONS: Readmissions lead to an excessive consumption
of health resources by a small percentage of patients. It
is crucial to find the key to control this phenomenon as
well as the expense involved and the detrimental to the
patient’s prognosis. Characteristics of these patients in
our health area are similar to those obtained in previous
studies, although the most frequent disease among
readmissions in 2017 in the HCULB is personality disorder
and the most frequent reason for admission is the autolytic
gesture, instead of schizophrenia or affective disorders as
main diagnosis and the exacerbation of their underlying
disorder as the main reason of admission, which had been
highlighted in literature. KEYWORDS: readmissions,
Revolving door, psychiatry, mental health",
}