Silva M, Antunes A, Loureiro A, Azeredo-Lopes S, Saraceno B, Caldas-de-Almeida J M, Cardoso G
Comprehensive Health Research Centre (CHRC), Nova Medical School, Nova University of Lisbon, Rua do Instituto Bacteriológico, n°5, 1150-190 Lisbon, Portugal; Lisbon Institute of Global Mental Health, Lisbon, Portugal.
Centre of Studies on Geography and Spatial Planning (CEGOT), Faculty of Arts and Humanities, Coimbra, Portugal.
Psychiatry Res. 2020 Nov;293:113420. doi: 10.1016/j.psychres.2020.113420. Epub 2020 Aug 20.
Assessing the factors that influence duration and number of hospitalizations may support mental health services planning and delivery. This study examines the factors associated with length of stay and readmission in Portuguese psychiatric inpatient services during 2002, 2007 and 2012. Data from all admissions were extracted from clinical files. Logistic regression models estimated the association between length of stay (<17 vs ≥17 days) and number of admissions per year (1 vs >1 admission) with sociodemographic, clinical, and contextual factors. Older age, a diagnosis of psychosis, and compulsory admission were associated with higher odds of longer length of stay. Being married, secondary education, suicide attempt, a diagnosis of substance use and "other mental disorders", being admitted in 2012, and two of the psychiatric inpatient services associated with lower odds of longer length of stay. Being retired (or others), a diagnosis of psychosis, compulsory admission, and psychiatric service were associated with increased odds of readmission. Older age, and secondary and higher education were associated with lower odds of readmission. The findings indicate that multiple factors influence length of stay and readmission. Identifying these factors provides useful evidence for clinicians and policy makers to design more targeted and cost-effective interventions.
评估影响住院时长和住院次数的因素可能有助于心理健康服务的规划与提供。本研究考察了2002年、2007年和2012年葡萄牙精神科住院服务中与住院时长和再入院相关的因素。所有入院患者的数据均从临床档案中提取。逻辑回归模型估计了住院时长（<17天与≥17天）和每年入院次数（1次与>1次）与社会人口学、临床和背景因素之间的关联。年龄较大、患有精神病诊断以及强制入院与住院时间较长的较高几率相关。已婚、接受中等教育、有自杀企图、患有物质使用障碍和“其他精神障碍”诊断、于2012年入院以及其中两个精神科住院服务与住院时间较长的较低几率相关。退休（或其他情况）、患有精神病诊断、强制入院以及精神科服务与再入院几率增加相关。年龄较大以及接受中等和高等教育与再入院几率较低相关。研究结果表明，多种因素影响住院时长和再入院。识别这些因素为临床医生和政策制定者设计更具针对性和成本效益更高的干预措施提供了有用的证据。
