Department of Health Care Administration, Central Taiwan University of Science and Technology, Taichung, Taiwan.
Clinics (Sao Paulo). 2010 May;65(5):481-9. doi: 10.1590/S1807-59322010000500005.
To explore the risks and rates of readmission and their predictors 14 days, one year, and five years after discharge for the psychiatric population in Taiwan.
This was a prospective study based on claims from 44,237 first-time hospitalized psychiatric patients discharged in 2000, who were followed for up to five years after discharge. The cumulative incidence and incidence density of readmission were calculated for various follow-up periods after discharge, and Cox proportional hazard models were generated to identify the significant predictors for psychiatric readmission.
The less than 14-day, one-year, and five-year cumulative incidences were estimated at 6.1%, 22.3%, and 37.8%, respectively. The corresponding figures for incidence density were 4.58, 1.04, and 0.69 per 1,000 person-days, respectively. Certain factors were significantly associated with increased risk of readmission irrespective of the length of follow-up, including male gender, length of hospital stay >15 days, economic poverty, a leading discharge diagnosis of schizophrenia/affective disorders, and residence in less-urbanized regions. Compared to children/adolescents, young adults (20-39 years) were significantly associated with increased risks of <one-year and <five-year readmissions, but not <14-day readmission. Additionally, hospital characteristics were significantly associated with increased risk of <14-day and <one-year readmission, but not with risk of <five-year readmission.
This study found that the significant predictors for psychiatric readmission 14 days to five years after discharge were essentially the same except for patient's age and hospital accreditation level. This study also highlighted the importance of socioeconomic factors in the prediction of readmission.
探讨台湾精神科人群出院后 14 天、1 年和 5 年的再入院风险和再入院率及其预测因素。
这是一项基于 2000 年首次住院的 44237 名精神科患者出院后长达 5 年的随访时间的前瞻性研究。计算了不同随访时间段的再入院累积发生率和发生率密度，并生成 Cox 比例风险模型，以确定精神科再入院的显著预测因素。
出院后 14 天、1 年和 5 年的累积发生率分别估计为 6.1%、22.3%和 37.8%。相应的发生率密度分别为每 1000 人日 4.58、1.04 和 0.69。无论随访时间长短，某些因素与再入院风险增加显著相关，包括男性、住院时间>15 天、经济贫困、主要出院诊断为精神分裂症/情感障碍以及居住在欠发达地区。与儿童/青少年相比，年轻人（20-39 岁）与 1 年和 5 年再入院风险增加显著相关，但与 14 天再入院风险无关。此外，医院特征与 14 天和 1 年再入院风险增加显著相关，但与 5 年再入院风险无关。
本研究发现，出院后 14 天至 5 年的精神科再入院的显著预测因素基本相同，除了患者年龄和医院认证级别。本研究还强调了社会经济因素在再入院预测中的重要性。
