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精神疾病是再次入院的风险因素吗?

Is Mental Illness a Risk Factor for Hospital Readmission?

作者信息

Gopalan Kalyani, Lennon Marcela Horvitz, Stein Bradley D, Ghinassi Frank, Castle Nicholas, Chang Joyce, Donohue Julie

机构信息

University of Pittsburgh School of Public Health, 130 De Soto Street, Pittsburgh, PA, 15213, USA.

RAND Corporation, Santa Monica, CA, USA.

出版信息

Adm Policy Ment Health. 2018 Nov;45(6):933-943. doi: 10.1007/s10488-018-0874-x.

Abstract

People with mental illnesses (MI) receive suboptimal care for medical comorbidities and their high risk for readmission may be addressed by adequate medication management and follow-up care. We examined the association between MI, medication changes, and post-discharge outpatient visits with 30-day readmission in 40,048 Medicare beneficiaries hospitalized for acute myocardial infarction, heart failure or pneumonia. Beneficiaries with MI were more likely to be readmitted than those without MI (14 vs. 11%). Probability of readmission was 13 and 12% when medications were dropped or added, respectively, versus 11% when no change was made. Probability of readmission also increased with outpatient visits.

摘要

患有精神疾病(MI)的人在治疗合并症方面接受的护理不够理想,而通过适当的药物管理和后续护理可以解决他们再次入院的高风险问题。我们在40,048名因急性心肌梗死、心力衰竭或肺炎住院的医疗保险受益人中,研究了精神疾病、药物变化以及出院后门诊就诊与30天再入院之间的关联。患有精神疾病的受益人比没有精神疾病的受益人更有可能再次入院(14%对11%)。当停用或添加药物时,再入院的概率分别为13%和12%,而未发生变化时为11%。再入院的概率也随着门诊就诊次数的增加而增加。

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