Shafer Alan
Tex Med. 2019 May 1;115(5):e1.
The primary purpose of the study was to examine the role public sector payers (Medicare and Medicaid) and providers (Texas state mental health hospitals) play in psychiatric hospitalization, using Texas annual hospital discharge files from 1999 to 2010. Psychiatric hospitalization, as defined by a primary behavioral health diagnosis (ICD-9 diagnoses 290-314.99) averaged 146,876 discharges per year, approximately 5.24% of all hospitalizations in the state. Children younger than 18 years accounted for 27,035 discharges per year. The top 4 diagnostic groups were depression (29%), bipolar disorder (22%), schizophrenia (18%), and alcohol-drug disorders (14%). More patients with schizophrenia or other psychotic disorders were served by the public sector, while more patients with depression or alcohol-drug disorders were served by private insurance. Interestingly, patients with bipolar disorder were distributed relatively evenly across both payment groups and ages. Length of stay decreased from 10.5 days in 1999 to 8.1 days in 2010. Most psychiatric discharges (69%) were served by a small group of 42 large psychiatric hospitals.
本研究的主要目的是利用1999年至2010年得克萨斯州年度医院出院档案，考察公共部门支付方（医疗保险和医疗补助）及医疗服务提供者（得克萨斯州立精神病医院）在精神病住院治疗中所起的作用。根据主要行为健康诊断（国际疾病分类第九版诊断编码290 - 314.99）定义的精神病住院治疗，平均每年出院146,876人次，约占该州所有住院治疗人次的5.24%。18岁以下儿童每年出院27,035人次。排名前4的诊断类别为抑郁症（29%）、双相情感障碍（22%）、精神分裂症（18%）和酒精 - 药物障碍（14%）。公共部门服务的精神分裂症或其他精神障碍患者更多，而私人保险服务的抑郁症或酒精 - 药物障碍患者更多。有趣的是，双相情感障碍患者在支付方组和各年龄段中的分布相对均匀。住院时间从1999年的10.5天降至2010年的8.1天。大多数精神病出院患者（69%）由42家大型精神病医院组成的一小部分医院服务。
