Timely outpatient follow-up and readmission risk in schizophrenia
- 1Jeju Institute of Public Health and Health Policy, Jeju National University Hospital , ,
Abstract
Timely outpatient follow-up after psychiatric hospitalization has been proposed as a key strategy to reduce readmission; however, evidence in patients with first-admission schizophrenia remains limited. Using the Korean National Health Insurance Claims Database, we conducted a nationwide retrospective cohort study of 1,961 patients with first-admission schizophrenia, defined as having no psychiatric service utilization during the preceding three years. We examined whether outpatient follow-up within 30 days after discharge was associated with the risk of readmission within 365 days. Adjusted Cox proportional hazards models were used to estimate hazard ratios across multiple cumulative follow-up periods (60, 90, 120, 150, 180, and 365 days), controlling for sociodemographic and clinical factors. Kaplan–Meier analysis was used to assess differences in readmission-free survival. Among the study population, 53.2% received outpatient follow-up within 30 days after discharge. When evaluated across progressively longer cumulative follow-up periods, outpatient follow-up was associated with a significantly lower risk of readmission at 60 days (aHR = 0.52, 95% CI: 0.29–0.95), 90 days (aHR = 0.55, 95% CI: 0.35–0.88), 120 days (aHR = 0.63, 95% CI: 0.43–0.94), 150 days (aHR = 0.66, 95% CI: 0.46–0.95), and 180 days (aHR = 0.70, 95% CI: 0.51–0.98), but not at 365 days (aHR = 0.79, 95% CI: 0.61–1.02). Kaplan–Meier analysis showed longer readmission-free survival in the follow-up group, although the difference was more pronounced over shorter follow-up durations. Timely outpatient follow-up was associated with reduced readmission risk over shorter cumulative follow-up periods, with attenuation of the association as the follow-up duration increased.
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BibTeX
@article{jeong2026timely,
title = {{Timely outpatient follow-up and readmission risk in schizophrenia}},
author = {Ji Woon Jeong and Hyeyoung Yoo and Hyeung-Keun Park},
journal = {Frontiers in psychiatry},
year = {2026},
month = sep,
doi = {10.3389/fpsyt.2026.1922379},
url = {https://europepmc.org/article/PMC/PMC13661966},
note = {CC BY},
}
RIS
TY - JOUR
TI - Timely outpatient follow-up and readmission risk in schizophrenia
AU - Ji Woon Jeong
AU - Hyeyoung Yoo
AU - Hyeung-Keun Park
PY - 2026
DA - 2026/09/30
JO - Frontiers in psychiatry
DO - 10.3389/fpsyt.2026.1922379
UR - https://europepmc.org/article/PMC/PMC13661966
AB - Timely outpatient follow-up after psychiatric hospitalization has been proposed as a key strategy to reduce readmission; however, evidence in patients with first-admission schizophrenia remains limited. Using the Korean National Health Insurance Claims Database, we conducted a nationwide retrospective cohort study of 1,961 patients with first-admission schizophrenia, defined as having no psychiatric service utilization during the preceding three years. We examined whether outpatient follow-up within 30 days after discharge was associated with the risk of readmission within 365 days. Adjusted Cox proportional hazards models were used to estimate hazard ratios across multiple cumulative follow-up periods (60, 90, 120, 150, 180, and 365 days), controlling for sociodemographic and clinical factors. Kaplan–Meier analysis was used to assess differences in readmission-free survival. Among the study population, 53.2% received outpatient follow-up within 30 days after discharge. When evaluated across progressively longer cumulative follow-up periods, outpatient follow-up was associated with a significantly lower risk of readmission at 60 days (aHR = 0.52, 95% CI: 0.29–0.95), 90 days (aHR = 0.55, 95% CI: 0.35–0.88), 120 days (aHR = 0.63, 95% CI: 0.43–0.94), 150 days (aHR = 0.66, 95% CI: 0.46–0.95), and 180 days (aHR = 0.70, 95% CI: 0.51–0.98), but not at 365 days (aHR = 0.79, 95% CI: 0.61–1.02). Kaplan–Meier analysis showed longer readmission-free survival in the follow-up group, although the difference was more pronounced over shorter follow-up durations. Timely outpatient follow-up was associated with reduced readmission risk over shorter cumulative follow-up periods, with attenuation of the association as the follow-up duration increased.
SN - 1664-0640
ER -