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日本精神分裂症和双相情感障碍患者精神病住院和再住院后的及时随访。

Timely follow-up visits after psychiatric hospitalization and readmission in schizophrenia and bipolar disorder in Japan.

机构信息

Research Department, Institute for Health Economics and Policy, Association for Health Economics Research and Social Insurance and Welfare, Tokyo, Japan; Department of Psychiatry and Behavioral Science, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan.

Numazu Chuo Hospital, Fukkokai Foundation, Shizuoka, Japan.

出版信息

Psychiatry Res. 2018 Dec;270:490-495. doi: 10.1016/j.psychres.2018.10.020. Epub 2018 Oct 9.

Abstract

The study objective was to investigate the association between timely follow-up visits after psychiatric hospitalization and the risk of readmission in patients with schizophrenia or bipolar disorder. A retrospective cohort study was conducted using a nationwide claims database in Japan. Between April 2014 and March 2015, all psychiatric hospitalization data were obtained and patients with a principal diagnosis of schizophrenia or bipolar disorder were followed up from 180 days before admission to 210 days after discharge. The primary outcome of this study was psychiatric readmission during the 180-day period (between 31 and 210 days) after the index discharge. A total of 48,579 eligible patients were identified. After psychiatric hospitalization, 15% of patients received no follow-up visits to a psychiatrist within 30 days. Patients who received follow-up visits had lower readmission rates during the subsequent 180 days (21.7% vs. 37.5%; adjusted risk ratio, 0.54 [95% confidence interval, 0.52-0.57]) than those who did not. Timely follow-up visits after discharge could be helpful for reducing the readmission risk in patients.

摘要

研究目的在于探究精神科住院后及时随访与精神分裂症或双相情感障碍患者再入院风险之间的关系。本研究采用日本全国范围内的索赔数据库进行了一项回顾性队列研究。2014 年 4 月至 2015 年 3 月间,获取了所有精神科住院数据,并对主要诊断为精神分裂症或双相情感障碍的患者进行了随访,随访时间从入院前 180 天至出院后 210 天。本研究的主要结局为出院后 180 天(31 至 210 天)内的精神科再入院情况。共确定了 48579 名符合条件的患者。在精神科住院后,15%的患者在 30 天内未接受精神科医生的随访。与未接受随访的患者相比,接受随访的患者在随后的 180 天内再入院率更低(21.7%比 37.5%;调整后的风险比为 0.54 [95%置信区间,0.52-0.57])。出院后及时随访有助于降低患者的再入院风险。

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