Care concerns and readmission patterns among individuals in inpatient mental health in Ontario, Canada

Readmissions to inpatient mental health settings reflect an important health system indicator. Understanding primary care concerns identified during inpatient mental health assessment, and factors contributing to readmissions is crucial to improving the quality of care and clinical outcomes. This study compares sociodemographic and clinical care characteristics across care transitions (i.e. admission, discharge, and readmission); and identifies classifications of care concerns at readmission among individuals in inpatient mental health settings in Ontario, Canada. Data were extracted from the Ontario Mental Health Reporting System (OMHRS), encompassing individuals aged ≥ 18 years with an initial inpatient admission between January 1, 2016, and December 31, 2022. Bivariate analyses compared characteristics between individuals with and without 30-day readmissions, and latent class analysis identified care concern profiles using Collaborative Action Plans, standardized decision-support tools used to identify areas requiring clinical intervention. A total of 56,836 individuals were included, with 4,644 (8.2%) individuals experiencing a mental health-related readmission within 30 days of discharge. Sociodemographic and clinical characteristics differed across care transitions and readmission status. Latent class analysis identified two distinct profiles (i.e. Limited Care Concerns, and Increased Care Concerns) based on patterns of triggered CAPs at admission and readmission. Findings highlight the complex interplay of individual and system-level factors contributing to psychiatric readmissions, and can inform targeted interventions, and early identification for individuals at increased risk of inpatient mental health readmission. Findings from this study also suggest broader system-level factors, such as care coordination, as integral to clinical strategies to reduce readmissions.