Holdsworth La Elizabeth, Zhu Ruoqing, Hassmiller Lich Kristen, Ellis Alan R, Swartz Marvin S, Kosorok Michael R, Morrissey Joseph P
Department of Health Policy and Management, University of North Carolina at Chapel Hill, Campus Box 7411, Chapel Hill, NC, 27599, USA,
Adm Policy Ment Health. 2015 May;42(3):332-42. doi: 10.1007/s10488-014-0573-1.
This study examined the effects of a waitlist policy for state psychiatric hospitals on length of stay and time to readmission using data from North Carolina for 2004-2010. Cox proportional hazards models tested the hypothesis that patients were discharged "quicker-but-sicker" post-waitlist, as hospitals struggled to manage admission delays and quickly admit waitlisted patients. Results refute this hypothesis, indicating that waitlists were associated with increased length of stay and time to readmission. Further research is needed to evaluate patients' clinical outcomes directly and to examine the impact of state hospital waitlists in other areas, such as state hospital case mix, local emergency departments, and outpatient mental health agencies.
本研究利用北卡罗来纳州2004 - 2010年的数据，考察了州立精神病医院的等候名单政策对住院时长和再入院时间的影响。考克斯比例风险模型检验了这样一个假设：由于医院努力应对入院延迟并迅速收治等候名单上的患者，患者在等候名单之后出院时“更快但病情更重”。结果反驳了这一假设，表明等候名单与住院时长和再入院时间的增加有关。需要进一步的研究来直接评估患者的临床结局，并考察州立医院等候名单在其他领域的影响，如州立医院的病例组合、当地急诊科和门诊心理健康机构。
