认证对精神科住院患者住院时间的影响：认证前后病历比较
Effect of accreditation on length of stay in psychiatric inpatients: pre-post accreditation medical record comparison.
作者信息
Al-Sughayir Mohammed Abdullah
机构信息
Psychiatry Department, College of Medicine, King Saud University, PO Box 21525, Riyadh, 11485 Kingdom of Saudi Arabia.
出版信息
Int J Ment Health Syst. 2016 Sep 7;10(1):55. doi: 10.1186/s13033-016-0090-6. eCollection 2016.
BACKGROUND
An interest in hospital accreditation is growing rapidly among many countries to enhance the quality of health care services. The literature showed a positive association between accreditation and some processes of health care. One of the main factors that influence bed availability is the length of hospital stay (LOS), which is considered as an important indicator of the quality of inpatient psychiatric hospitalization. We aimed to investigate whether hospital accreditation drives improvements for the length of stay in psychiatric inpatients.
METHODS
The study reviewed medical records of consecutive hospital admissions for pre- and post-accreditation comparisons of LOS in two acute mental health wards at a teaching general hospital in Riyadh, Saudi Arabia. Data obtained from the 12-month-post-accreditation period (July 2011 to June 2012) were compared with those from the 12-month-pre-accreditation period (July 2009 to June 2010). The adoption of accreditation program occurred over a 12-month period in the middle of the study (July 2010 to June 2011). Compiled information included demographics, diagnosis, assessment, and LOS. All identified charts were reviewed; there were no exclusion criteria. Patients were not contacted.
RESULTS
Post-accreditation, the mean (SD) length of stay was 35.3 ± 18.5 days and the range was 3-113 days. Whereas in the pre-accreditation period the mean (SD) length of stay was 41.1 ± 29.5 days and the range was 1-167 days. The difference was statistically significant (P = 0.026).
CONCLUSION
Accreditation reduces excess LOS and contributes to improving the quality of psychiatric inpatient care and access to psychiatric beds.
背景
许多国家对医院评审的关注度正在迅速增长，以提高医疗服务质量。文献表明评审与某些医疗过程之间存在正相关关系。影响床位可用性的主要因素之一是住院时间（LOS），它被视为住院精神科治疗质量的重要指标。我们旨在调查医院评审是否推动了精神科住院患者住院时间的改善。
方法
该研究回顾了沙特阿拉伯利雅得一家教学综合医院两个急性精神科病房在评审前后连续住院患者的病历，以比较住院时间。将2011年7月至2012年6月评审后12个月期间的数据与2009年7月至2010年6月评审前12个月期间的数据进行比较。评审计划在研究中期的12个月期间（2010年7月至2011年6月）实施。汇编的信息包括人口统计学、诊断、评估和住院时间。所有识别出的病历均经过审查；没有排除标准。未与患者联系。
结果
评审后，平均（标准差）住院时间为35.3±18.5天，范围为3至113天。而在评审前期间，平均（标准差）住院时间为41.1±29.5天，范围为1至167天。差异具有统计学意义（P = 0.026）。
结论
评审减少了过长的住院时间，有助于提高精神科住院护理质量和精神科床位的可及性。
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