Despite the existence of numerous studies on psychiatric readmissions; a knowledge gap concerning the association of health and social systems as well as environmental characteristics on readmissions rates of inpatients discharged from psychiatric diagnosis care is scare. In the article “Psychiatric readmissions and their association with environmental and health system characteristics: a systematic review of the literature” Kalseth, et al. (2016) sought to determine whether health system and environmental factors influence the rate of readmissions. While the study provides valuable findings concerning the association between psychiatric readmissions and health system and environmental factors, the results have some deficiencies related to sample size, replicability, and generalizability of the results.

Kalseth et al. (2016) used a sample of 35 to examine the influence of health systems and environmental characteristics on cases of readmissions of discharged psychiatric patients. In line with the objective of the study which focused on establishing the relationship between the health system and environmental characteristics and rate of readmission, the researchers categorized the various variables from the 35 studies into three principal categories. Majority of the studies reviewed, 24 out of 35 focused on capacity, organization, and structure of the health care providers. Eight of the studies focused on environmental characteristics and these included geographical, demographic and socio-economic factors. Lastly, only three of the 35 articles reviewed tacked the issue of regulation, financing and governance structures. The studies used different type and level of analysis. While eight articles used intervention study, five were considered as original studies, six as aggregated studies and the remaining 16 observational. Interpretation of findings of the 35 studies reveal conflicting but essential information concerning the relationship between psychiatric readmissions and the different predictor variables covered. In general, the study concluded the importance of the health system and other contextual factors related to the organization on readmission rates. The researchers advised that it is essential to understand the association between a health system and environmental factors and cases of psychiatric readmissions in coming up with policy developments, planning, and organization of mental health treatment.

The high number of readmissions rates of patients with mental conditions has been a concern for a while. To provide comprehensive information on the association between readmission rates and health system as well as environmental characteristics, Kalseth et al. (2016) embarked on a systematic review of existing knowledge with the objective of filling the knowledge gap. While the study came established the various factors that influence cases of readmissions among patients diagnosed psychiatric conditions and recommends the need to pay attention to them, there are some issues concerning the generalizability and consistency of the findings. The key concern about the study is the specific instrument used in the qualitative synthesis of the data the researchers were able to extract from the final 35 articles that met the requirements set for inclusion and eligibility.  Concerning the three categories of environmental and system characteristics, it is not clear why the researchers decided to come up with three groups instead of two. Concerning results, type and level of analysis, the researchers made a good effort of identifying the most comprehensive articles to include in the study.  Despite this, there is a sense of confusion about analysis and discussion of the results from the study. The researchers in the study followed no clear and objective trend. In addition to this, the researchers did not attempt to summarize their findings in a form that is easy to follow concerning the specific factors that were prominent in the analysis. For instance, there is a lack of clarity concerning findings on environmental factors and how they influence readmissions rates. While two studies found lower readmission rates in urban regions, the researchers fail to explain what the other six studies were able to establish.

The article focused on establishing the relationship between psychiatric readmission rates and health systems as well as environmental factors. One of the key findings that should inform the provision of mental health services is the need to give patients adequate time for treatment. In addition to this, follow-up activities and need to for more providers per population arose. Though findings from Kalseth et al. (2016) systematic literature review on the relationship between readmission and health and environmental characteristics are conflicting, their research provides detailed information on the possible factors that influence readmission rates. For more conclusive research, there is a need for future research to focus on each of the elements separately and use concrete data obtained from various facilities providing psychiatric care.

Reference

Kalseth, J., Lassemo, E., Wahlbeck, K., Haaramo, P., & Magnussen, J. (2016). Psychiatric

readmissions and their association with environmental and health system characteristics: a systematic review of the literature. BMC Psychiatry, 16(1), 376.