Suh Soo Kyung, Kim Yoon, Park Jong-Ik, Lee Myung-Soo, Jang Hong-Suk, Lee Sun Young, Lee Jin-Seok
Department of Health Policy and Management, Seoul National University College of Medicine, Seoul, Korea.
J Prev Med Public Health. 2009 Nov;42(6):416-23. doi: 10.3961/jpmph.2009.42.6.416.
This study was performed to examine medical care utilization of psychiatric patients and to explore patients' characteristics associated with extended hospitalization.
Data were extracted from information of Korean Health Insurance Review and Assessment Service. All data associated with admission and outpatient clinic visit were analysed by patient characteristics. We selected first psychiatric admission patients who diagnosed mental and behavioral disorders due to use of alcohol (main disease code: F10), schizophrenia and related disorders (F20-29) and mood disorders (F30~33) from January to June 2005. We analysed status of admission, mean length of stay, regular access to outpatient clinic and rates of extended hospitalization during 3 years. Bivariate and multivariate analyses were conducted to identify factors associated with extended hospitalization.
The number of psychiatric patients during the first six month of 2005 was 30,678. The mean length of stay was longest for schizophrenia and related disorders but shortest for mood disorders. Patients who experienced an extended hospitalization were 18.8% of total subjects. An extended hospitalization was more common in schizophrenia and related disorders than other diagnostic groups. The factors associated with the extended hospitalization were age, sex, diagnostic group, type of insurance and medical care utilization groups.
The study indicates the problem of an extended hospitalization for psychiatric patients in Korea. It is suggested that variations in rates of extended hospitalization among medical care utilization group may need an active early intervention system in psychiatric treatment service. Particular attention needs to be devoted to planning and funding for reducing extended hospitalization.
本研究旨在调查精神病患者的医疗服务利用情况，并探索与长期住院相关的患者特征。
数据提取自韩国健康保险审查与评估服务机构的信息。所有与住院和门诊就诊相关的数据均按患者特征进行分析。我们选取了2005年1月至6月期间首次因使用酒精导致精神和行为障碍（主要疾病编码：F10）、精神分裂症及相关障碍（F20 - 29）和心境障碍（F30~33）而入院的精神病患者。我们分析了3年期间的住院情况、平均住院时长、定期门诊就诊情况以及长期住院率。进行了双变量和多变量分析以确定与长期住院相关的因素。
2005年前六个月的精神病患者数量为30678人。精神分裂症及相关障碍患者的平均住院时长最长，而心境障碍患者最短。长期住院患者占总研究对象的18.8%。与其他诊断组相比，精神分裂症及相关障碍患者中长期住院更为常见。与长期住院相关的因素包括年龄、性别、诊断组、保险类型和医疗服务利用组。
该研究表明韩国存在精神病患者长期住院的问题。建议针对医疗服务利用组中不同的长期住院率差异，在精神治疗服务中建立积极的早期干预系统。在规划和资金投入方面需要特别关注以减少长期住院情况。
