Lally John, Wong Yim Lun, Shetty Hitesh, Patel Anita, Srivastava Vivek, Broadbent Matthew T M, Gaughran Fiona
Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London and National Psychosis Service, South London and Maudsley NHS Foundation Trust, London, United Kingdom.
Coventry and Warwickshire Partnership NHS Trust, Coventry, United Kingdom.
Gen Hosp Psychiatry. 2015 Nov-Dec;37(6):577-80. doi: 10.1016/j.genhosppsych.2015.07.006. Epub 2015 Jul 26.
Standardized mortality ratios are twice the population average in the year following a mental health admission, yet there is a relative paucity of research on uptake of general medical care in psychiatric inpatients.
A retrospective database analysis was performed to ascertain the frequency of acute medical care usage by psychiatric inpatients. Data were gathered through a static linkage between anonymized clinical records in a large UK mental health provider and the national hospital activity database (Hospital Episode Statistics) over 1year from 2010 to 2011.
Over the year, 10.4% of the 8023 psychiatric admission episodes included at least one night in a general hospital during that psychiatric inpatient stay, while 12.0% of psychiatry admission episodes entailed an emergency department (ED) visit. Over the course of the full year, of the 4674 people admitted to the mental health provider at least once, 16.0% were admitted to a general hospital while registered as a mental health inpatient and 18.0% were seen in the ED. Patients were simultaneously registered as occupying beds in both general and psychiatric hospitals for a total of 5163 bed days at a cost of £2.4 million over the year.
This large population-based linkage study indicates a high rate of general hospital utilization by psychiatric inpatients in an independent mental health provider. The need for combined, flexible and practical approaches to the medical care of psychiatric inpatients is highlighted to reduce unplanned care and provide treatment in the site best suited to the patient's needs.
在因心理健康问题入院后的次年，标准化死亡率是人口平均水平的两倍，但针对精神科住院患者接受普通医疗服务情况的研究相对较少。
进行了一项回顾性数据库分析，以确定精神科住院患者使用急性医疗服务的频率。数据通过英国一家大型心理健康服务机构匿名临床记录与国家医院活动数据库（医院事件统计）在2010年至2011年的1年期间的静态链接收集。
在这一年中，8023例精神科住院病例中有10.4%在精神科住院期间至少有一晚在综合医院度过，而12.0%的精神科住院病例需要到急诊科就诊。在全年中，至少入院一次的4674名心理健康服务机构患者中，16.0%在注册为精神科住院患者时被收治到综合医院，18.0%在急诊科就诊。患者同时在综合医院和精神科医院占用床位，共计5163个床日，全年费用为240万英镑。
这项基于大量人群的链接研究表明，一家独立心理健康服务机构中的精神科住院患者对综合医院的利用率很高。强调需要采取综合、灵活且实用的方法来为精神科住院患者提供医疗服务，以减少计划外医疗并在最适合患者需求的地点提供治疗。
