Chiu Maria, Gatov Evgenia, Zaheer Juveria, Lebenbaum Michael, Fu Longdi, Newman Alice, Kurdyak Paul
Mental Health and Addictions Program, Institute for Clinical Evaluative Sciences, Toronto, Canada.
University of Toronto, Institute for Health Policy Management and Evaluation, Toronto, Canada.
BMJ Open. 2018 Jan 13;8(1):e020156. doi: 10.1136/bmjopen-2017-020156.
We sought to examine the short-term and long-term impacts of psychiatric hospitalisations among patients of Chinese and South Asian origin.
Retrospective population-based cohort study using linked health administrative data.
We examined all adult psychiatric inpatients discharged between 1 April 2006 and 31 March 2014 in Ontario, Canada, who were classified as Chinese, South Asian and all other ethnicities (ie, 'general population') using a validated algorithm. We identified 2552 Chinese, 2439 South Asian and 127 142 general population patients.
We examined psychiatric severity measures at admission and discharge and performed multivariable logistic regression analyses to examine 30-day, 180-day and 365-day postdischarge service utilisation and outcomes, comparing each of the ethnic groups with the reference population, after adjustment for age, sex, income, education, marital status, immigration status, community size and discharge diagnosis.
Despite presenting to hospital with greater illness severity, Asian psychiatric inpatients had shorter lengths of hospital stay and greater absolute improvements in mental health and functional status at discharge compared with other inpatients. After hospitalisation, Chinese patients were more likely to visit psychiatrists and South Asian patients were more likely to seek mental healthcare from general practitioners. They were also less likely to have a psychiatric readmission or die 1 year following hospitalisation (adjusted OR=0.87; 95% CI 0.79 to 0.97; adjusted OR=0.82, 95% CI 0.73 to 0.91). Findings were consistent across genders, psychiatric diagnoses and immigrant groups.
Once hospitalised, patients of Chinese and South Asian origin fared as well as or better than general population patients at discharge and following discharge, and had a positive trajectory of psychiatric service utilisation.
我们试图研究华裔和南亚裔患者精神病住院治疗的短期和长期影响。
基于人群的回顾性队列研究，使用关联的卫生行政数据。
我们研究了2006年4月1日至2014年3月31日期间在加拿大安大略省出院的所有成年精神科住院患者，这些患者使用经过验证的算法被分类为华裔、南亚裔和所有其他种族（即“一般人群”）。我们确定了2552名华裔、2439名南亚裔和127142名一般人群患者。
我们检查了入院和出院时的精神疾病严重程度指标，并进行了多变量逻辑回归分析，以检查出院后30天、180天和365天的服务利用情况和结局，在调整年龄、性别、收入、教育程度、婚姻状况、移民身份、社区规模和出院诊断后，将每个种族群体与参考人群进行比较。
尽管亚裔精神科住院患者入院时病情更严重，但与其他住院患者相比，他们的住院时间更短，出院时心理健康和功能状态的绝对改善更大。住院后，华裔患者更有可能去看精神科医生，南亚裔患者更有可能从全科医生那里寻求心理健康护理。他们在住院1年后再次入院或死亡的可能性也较小（调整后的比值比=0.87；95%置信区间0.79至0.97；调整后的比值比=0.82，95%置信区间0.73至0.91）。研究结果在不同性别、精神疾病诊断和移民群体中是一致的。
一旦住院，华裔和南亚裔患者在出院时及出院后的情况与一般人群患者相当或更好，并且有积极的精神科服务利用轨迹。
