Way B B, Banks S
New York State Office of Mental Health, Albany, 12229, USA.
Psychiatr Serv. 2001 Feb;52(2):214-8. doi: 10.1176/appi.ps.52.2.214.
The purpose of the study was to identify important clinical variables that influence admission and release decisions in psychiatric emergency services.
Physicians at four urban psychiatric emergency services rated 465 patients on ten clinical dimensions, including depression and psychosis. Information on five other variables-age, gender, ethnicity, diagnosis, and previous inpatient admission-were extracted from the patients' charts, as was information on case disposition.
Logistic regression produced a model with five variables that significantly predicted admission or release. In order of importance, they were level of danger to self, severity of psychosis, ability to care for self, impulse control, and severity of depression. The model explained 51 percent of the variance in case disposition and correctly classified 84 percent of the cases.
Guidelines addressing the variables that should be considered in making disposition decisions in psychiatric emergency services should be developed. The study found five variables that should be considered for inclusion.
本研究旨在确定影响精神科急诊服务中入院和出院决策的重要临床变量。
来自四个城市精神科急诊服务机构的医生在十个临床维度上对465名患者进行了评分，包括抑郁和精神病。从患者病历中提取了关于其他五个变量的信息——年龄、性别、种族、诊断和既往住院史，以及病例处置信息。
逻辑回归产生了一个包含五个变量的模型，这些变量显著预测了入院或出院情况。按重要性排序，它们分别是对自身的危险程度、精神病严重程度、自我照顾能力、冲动控制和抑郁严重程度。该模型解释了病例处置中51%的方差变异，并正确分类了84%的病例。
应制定指导方针，明确在精神科急诊服务中做出处置决策时应考虑的变量。该研究发现了五个应考虑纳入的变量。
