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 important findings concerning the association between psychiatric readmissions and health system and environmental factors, the results have a number of 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 health system and environmental characteristics and rate of readmission, the researchers categorized the various variables from the 35 studies into three key 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 8 articles used intervention study, 5 were considered as natural studies, 6 as aggregated studies and the remaining 16 observational. Analysis of findings of the 35 studies reveal conflicting but important information concerning the relationship between psychiatric readmissions and the different predictor variables covered. In general, the study concluded the significance of health system and other contextual factors related to organization on readmission rates. The researchers advised that it is important to understand the association between health system and environmental factors and cases of psychiatric readmissions in coming up with policy developments, planning and organization of mental health treatment.

High number of readmissions rates of patients with mental conditions has been a concern for a while. In an effort to provide comprehensive information on the association between readmission rates and health system as well as environmental characteristics, Kalseth et al (2016) embarked on 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 a number of issues concerning the generalizability and consistency of the findings. Key concern about the study is the specific instrument that was 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 categories 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 with regard to analysis and discussion of the results from the study. There is no clear and objective trend that was followed by the researchers in the study. In addition to this, the researchers did not make an attempt to summarize their findings in a form that is easy to follow with regard to the specific factors that were prominent in the analysis. For instance, there is 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 establishing the relationship between psychiatric readmission rates and health systems as well as environmental factors. One of the key findings that should inform 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 provide a detailed information on the possible factors that influence readmission rates. For more conclusive research, there is need for future research to focus on each of the factors 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.