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早期精神科再住院风险因素的识别。

Identification of risk factors for early psychiatric rehospitalization.

作者信息

Zhao Yihong, Hoenig Jennifer M, Protacio Angeline, Lim Sungwoo, Norman Christina C

机构信息

NYC Department of Health and Mental Hygiene, 42-09 28th Street, Long Island City, NY, 11101, USA; Center of Alcohol & Substance Use Studies, Department of Applied Psychology, Graduate School of Applied and Professional Psychology, Rutgers University, 607 Allison Road, Piscataway, NJ, 08854, USA.

NYC Department of Health and Mental Hygiene, 42-09 28th Street, Long Island City, NY, 11101, USA.

出版信息

Psychiatry Res. 2020 Jan 21;285:112803. doi: 10.1016/j.psychres.2020.112803.

Abstract

Identifying risk factors for early psychiatric rehospitalization (EPR, rehospitalization within 90 days) can inform strategies to reduce rehospitalization rates. Random forest (RF), a tree-based classification algorithm, can be useful for identifying potential risk factors for EPR from a large number of patient factors. Patient characteristics were collected from 519 psychiatric inpatients at eight New York City hospitals. RF was used to identify potential risk factors for EPR. Multiple logistic regression was performed to assess the association between the identified risk factors and rehospitalization. Top risk factors identified by RF were previous psychiatric hospitalizations, number of post-discharge needs, social isolation, and sense of belonging in one's community. Follow-up analyses confirmed the significant association between EPR and number of previous psychiatric hospitalizations, number of endorsed post-discharge needs, and social isolation after adjusting for demographic variables. Understanding the contributors to EPR can better inform mental health service planning, policies, and programs that promote recovery.

摘要

识别早期精神科再住院(EPR,90天内再住院)的风险因素可为降低再住院率的策略提供依据。随机森林(RF)是一种基于树的分类算法,可用于从大量患者因素中识别EPR的潜在风险因素。从纽约市八家医院的519名精神科住院患者中收集了患者特征。使用RF识别EPR的潜在风险因素。进行多因素逻辑回归以评估已识别的风险因素与再住院之间的关联。RF识别出的主要风险因素包括既往精神科住院史、出院后需求数量、社会隔离以及社区归属感。随访分析证实,在调整人口统计学变量后,EPR与既往精神科住院次数、认可的出院后需求数量和社会隔离之间存在显著关联。了解EPR的影响因素可以更好地为促进康复的心理健康服务规划、政策和项目提供信息。

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