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快速且频繁的精神科再入院:相关因素。

Rapid and frequent psychiatric readmissions: associated factors.

机构信息

a South London and Maudsley NHS Foundation Trust, Maudsley Hospital , London , UK.

b Institute of Psychiatry at King's College London , London , UK.

出版信息

Int J Psychiatry Clin Pract. 2017 Nov;21(4):271-276. doi: 10.1080/13651501.2017.1324037. Epub 2017 May 30.

Abstract

OBJECTIVE

This article aims to examine the impact of clinical and demographic factors on both rapid readmission (being readmitted within 30 d) and frequent readmission (experiencing three or more admissions) in a London mental health trust.

METHODS

A four-year study period with a sample of 7648 inpatients were examined with chi-square or Mann-Whitney U tests, and binary logistic regressions to assess the associations and possible predictors of rapid (readmitted within 30 d) and frequent (admitted at least three times) readmission.

RESULTS

Frequent admitters were more likely to be unemployed, have more care-coordinators, be living in accommodation with support, be Black or Black British, and to have certain diagnoses. Binary logistic regression revealed that our variables of interest explained between 36.1 and 60.9% of the variation in number of readmissions (±3 admissions), and between 3.7 and 4.2% of the variation in time to readmission (±30 d).

CONCLUSIONS

Identifying factors that are associated with rehospitalisation and understanding their importance is necessary to reduce the risk of readmission. This study suggests that particular demographic, clinical and treatment factors require consideration to tackle the seemingly wide range of factors that could be affecting readmission to inpatient services.

摘要

目的

本文旨在探讨临床和人口统计学因素对伦敦某心理健康信托机构患者的快速再入院(30 天内再次入院)和频繁再入院(三次或以上入院)的影响。

方法

对 7648 名住院患者进行了为期四年的研究,使用卡方检验或曼-惠特尼 U 检验以及二项逻辑回归分析来评估快速(30 天内再次入院)和频繁(至少三次入院)再入院的关联和可能的预测因素。

结果

频繁入院者更可能失业,有更多的护理协调员,居住在有支持的住所,是黑人或英籍黑人,且有某些特定的诊断。二项逻辑回归显示,我们关注的变量解释了再入院次数(±3 次)的 36.1%至 60.9%和再入院时间(±30 天)的 3.7%至 4.2%的差异。

结论

确定与再入院相关的因素及其重要性对于降低再入院风险是必要的。本研究表明,特定的人口统计学、临床和治疗因素需要考虑,以解决可能影响住院服务再入院的广泛因素。

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