Department of Psychiatry, Department of Veterans Affairs Boston Health Care System, 940 Belmont St., Brockton, MA 02301, USA.
Psychiatr Serv. 2012 Mar;63(3):283-6. doi: 10.1176/appi.ps.201000563.
This study identified characteristics of adult psychiatric patients who remained for 24 or more hours in the emergency departments of general hospitals in Massachusetts.
Data were collected starting in June 2008 on a prospective cohort of 1,076 patients who presented for emergency psychiatric evaluation at one of five hospitals.
A total of 90 patients (8%) stayed 24 or more hours (median=31 hours). More than 90% (N=1,018) of all patients had health insurance. Characteristics associated with extended stays included homelessness, transfer to another hospital, public insurance, and use of restraints or sitters (p<.05). The two academic medical centers had higher proportions of extended-stay patients than the three community hospitals (12% and 15% versus 1%, 7%, and 7%, respectively; p<.001).
Despite overall high rates of health insurance coverage, publicly insured patients waited longer than those with private insurance. Future reforms of Massachusetts' mandatory health insurance program should consider treatment capacity as well.
本研究旨在确定在马萨诸塞州综合医院急诊科停留 24 小时或更长时间的成年精神科患者的特征。
本研究于 2008 年 6 月开始，对在五家医院之一接受急诊精神评估的 1076 例患者进行了前瞻性队列研究。
共有 90 例患者（8%）停留 24 小时或更长时间（中位数=31 小时）。超过 90%（N=1018）的所有患者均有健康保险。与延长停留时间相关的特征包括无家可归、转院、公共保险和使用约束或坐椅（p<.05）。两所学术医疗中心的延长停留患者比例高于三家社区医院（分别为 12%和 15%，而 1%、7%和 7%；p<.001）。
尽管总体健康保险覆盖率较高，但参保的患者比私人保险患者等待时间更长。马萨诸塞州强制性医疗保险计划的未来改革应考虑治疗能力。
