Plancke Laurent, Amariei Alina, Flament Clara, Dumesnil Chloé
Sante Publique. 2017 Nov-Dec;29(6):829-836. doi: 10.3917/spub.176.0829.
Psychiatric readmission often constitutes a criterion to assess the effects of various therapies, as well as the impact of organizational changes in the healthcare system. It is used to characterize relapse or decompensation. The purpose of this study was to determine readmission rates and identify individual and organizational factors associated with significant variations in these rates.
Adult psychiatric readmissions were identified from the full-time hospital stays registered in psychiatric wards in 2011-2012 in the Nord and Pas-de-Calais departments of France, available in the medical the RimP psychiatric admission database. Readmission rates for various follow-up periods after discharge were measured by Kaplan-Meier survival analysis and multivariate analysis was conducted using the Cox proportional hazards model.
Approximately 30,000 adults were hospitalized full-time in psychiatric units of the region during the study period. The 24-month readmission rate was 51.6% (95%CI: 50.8-52.3%). The Cox model showed that a diagnosis of schizophrenia (F2 - HR = 1.72 - 95%CI: 1.61-1.84 - p < 0.001) and personality disorder (F6 - HR = 1.45 - 95%CI: 1.32-1.58 - p < 0.001) was associated with a higher readmission rate. Readmission rates were higher among dependent patients in non-profit private hospitals.
Psychiatric readmission is a very frequent event and is linked to organizational as well as individual factors.
精神科再入院通常是评估各种治疗效果以及医疗系统组织变革影响的一项标准。它被用于描述复发或失代偿情况。本研究的目的是确定再入院率，并识别与这些率的显著差异相关的个体和组织因素。
从法国北部和加来海峡省2011 - 2012年精神科病房登记的全日制住院病例中识别成年精神科再入院病例，这些病例可在RimP精神科入院数据库中获取。通过Kaplan - Meier生存分析测量出院后不同随访期的再入院率，并使用Cox比例风险模型进行多变量分析。
在研究期间，该地区约30,000名成年人在精神科病房全日制住院。24个月的再入院率为51.6%（95%置信区间：50.8 - 52.3%）。Cox模型显示，精神分裂症诊断（F2 - 风险比 = 1.72 - 95%置信区间：1.61 - 1.84 - p < 0.001）和人格障碍（F6 - 风险比 = 1.45 - 95%置信区间：1.32 - 1.58 - p < 0.001）与较高的再入院率相关。非营利性私立医院中依赖患者的再入院率更高。
精神科再入院是一个非常常见的事件，并且与组织因素以及个体因素都有关联。
