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基于诊断程序组合信息评估日本的精神科结局。

Assessment of psychiatric outcomes in Japan based on diagnostic procedure combination information.

机构信息

Department of Health Services, Management and Policy, Kyushu University Graduate School of Medicine, Fukuoka, Japan.

出版信息

Psychiatr Q. 2011 Jun;82(2):163-75. doi: 10.1007/s11126-010-9158-7.

Abstract

We evaluated psychiatric care in terms of relationships between patient characteristics and a comprehensive measurement of psychiatric outcomes among inpatients with lengths of stay (LOSs) of 90 days or fewer in a psychiatric hospital in Japan. The sample consisted of inpatients discharged from an acute care psychiatric hospital between September 1 and December 31, 2007. Multivariate analyses were performed to identify patient characteristics related to the outcome of acute psychiatric care. The type of admission was related to difference in Global Assessment of Functioning (GAF) scores (P < 0.001), health care cost (P < 0.001), length of time spent in seclusion (P < 0.001), and length of time spent in restraints (P < 0.01). Diagnosis showed a minimal or non-existent relationship to the outcome variables. The GAF scores of involuntary patients with initially low scores on this axis were greatly improved at discharge. Patients who were admitted involuntarily received more coercive interventions and treatments, such as seclusion and restraints, than did patients with who were admitted voluntarily. Diagnostic groups did not differ in terms of GAF scores. Further studies utilizing diagnostic procedure combination (DPC) data from multiple medical institutions are necessary to verify the present findings.

摘要

我们评估了精神科护理,根据患者特征与在日本一家精神病院住院时间(LOS)为 90 天或更短的住院患者的综合精神科结果测量之间的关系。样本包括 2007 年 9 月 1 日至 12 月 31 日从急性护理精神病院出院的患者。进行了多变量分析,以确定与急性精神科护理结果相关的患者特征。入院类型与总体功能评估(GAF)评分(P<0.001)、医疗保健费用(P<0.001)、隔离时间(P<0.001)和约束时间(P<0.01)的差异有关。诊断与结局变量之间关系不大或不存在。在这个轴上最初得分较低的非自愿患者的 GAF 评分在出院时得到了极大改善。与自愿入院的患者相比,非自愿入院的患者接受了更多的强制性干预和治疗,如隔离和约束。不同的诊断组在 GAF 评分方面没有差异。需要利用来自多个医疗机构的诊断程序组合(DPC)数据进行进一步研究,以验证本研究结果。

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