Hayley D. Germack PHD, MHS, RN Assistant Professor, School of Nursing University of Pittsburgh

Serious Mental Illness Raises Risk of 30 Day Readmission

MedicalResearch.com Interview with:

Hayley D. Germack PHD, MHS, RN Assistant Professor, School of Nursing University of Pittsburgh

Dr. Germack

Hayley D. Germack PHD, MHS, RN
Assistant Professor, School of Nursing
University of Pittsburgh

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: As nurse scientists, we repeatedly witness the impact of having a serious mental illness (i.e. schizophrenia, bipolar disorder, and major depression disorder) on patients’ inpatient and discharge experience. As health services researchers, we know how to make use of large secondary data to illuminate our firsthand observations.

In 2016, Dr. Hanrahan and colleagues (https://www.sciencedirect.com/science/article/pii/S0163834316301347) published findings of a secondary data analysis from a large urban hospital system that found 1.5 to 2.4 greater odds of readmission for patients with an  serious mental illness diagnosis compared to those without. We decided to make use of the AHRQ’s HCUP National Readmissions Database to illuminate the magnitude of this relationship using nationally representative data. We found that even after controlling for clinical, demographic, and hospital factors, that patients with SMI have nearly 2 times greater odds of 30-day readmission. 

MedicalResearch.com: What should readers take away from your report?

Response: Patients with .serious mental illness have a substantially greater odds of readmission within 30 days of discharge compared to those without. Clinically, when caring for these vulnerable patients on general medical or surgical units, we ought to do everything within our capacity as inpatient providers to make their transition to the community as seamless as possible.  

MedicalResearch.com: What recommendations do you have for future research as a result of this work? 

Response: This study has implications for future research, policy, and practice. We recommend further research exploring modifiable characteristics of hospitals and health systems—particularly examining policies and practices that promote safer transitions from hospital to community for this vulnerable population. We also recommend further research into identifying variation and potential sources of variation in readmissions for people with SMI.


Germack HD, Noor-E-Alam M, Wang X, Hanrahan N. Association of Comorbid Serious Mental Illness Diagnosis With 30-Day Medical and Surgical Readmissions. JAMA Psychiatry. Published online November 21, 2018. doi:10.1001/jamapsychiatry.2018.3091

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Last Updated on November 22, 2018 by Marie Benz MD FAAD