Słupczyńska-Kossobudzka E, Wierzbicki S
Instytutu Psychiatrii i Neurologii, Warszawie.
Psychiatr Pol. 1992 May-Aug;26(3-4):265-74.
The aim of the following research was to present and try to explain the features of chronic hospitalizations in psychiatric hospitals in Poland during the 1980's. According to the definition adopted when working with inpatients, patients hospitalized for over one year are regarded as chronic. The percentage of chronic patients in the general patient population was found to be 8% of all hospitalizations. The largest number of chronically hospitalized patients was found among those diagnosed as mentally retarded (29%) and schizophrenic (15%). The least number of chronic hospitalizations was found among patients with a diagnosis of alcoholism (1%) and among the non-psychotic patients (4%). In the years 1980 to 1989 there was a systematic fall in the previously increasing rate of chronic hospitalizations of people diagnoses as non-alcoholic psychotic and mentally retarded to about 70% of the number registered at the beginning of the decade. The fall in the rate of increase of chronic hospitalization is mainly due to the fall in the rate of growth of the chronically hospitalized group. This fall is not significantly connected with the movement of patients to community based services or with the increased mortality rate during the 1980's. The causes of this phenomenon remain unanswered. It may be the result of the better and more accessible forms of treatment, such as intermediate treatment, which are an alternative to long-term hospitalizations. Another reason may be the more effective forms of hospital treatment and the fact that psychiatric hospitals are using the "revolving door" strategy.
以下研究的目的是呈现并尝试解释20世纪80年代波兰精神病院长期住院患者的特征。根据处理住院患者时采用的定义,住院超过一年的患者被视为长期住院患者。长期住院患者在全体住院患者中的比例为所有住院患者的8%。长期住院患者数量最多的是那些被诊断为智力低下的患者(29%)和精神分裂症患者(15%)。长期住院患者数量最少的是诊断为酒精中毒的患者(1%)和非精神病患者(4%)。在1980年至1989年期间,之前被诊断为非酒精性精神病和智力低下的患者长期住院率呈上升趋势,之后开始系统性下降,降至该十年初记录数量的约70%。长期住院率增长速度的下降主要是由于长期住院患者群体增长速度的下降。这种下降与患者向社区服务机构转移的情况或20世纪80年代死亡率的上升没有显著关联。这一现象的原因尚不清楚。这可能是由于有了更好且更容易获得的治疗形式,如替代长期住院治疗的中间治疗。另一个原因可能是医院治疗形式更有效,以及精神病院采用了“旋转门”策略。