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日本精神科护理床位的长期住院患者人数:来自患者调查和 630 调查的趋势分析。

Number of long-term inpatients in Japanese psychiatric care beds: trend analysis from the patient survey and the 630 survey.

机构信息

Department of Neuropsychiatry, Osaka Medical College, 2-7 Daigakumachi, Takatsuki, Osaka, 569-8686, Japan.

Department of Mental Health Policy, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4 Chome-1-1 Ogawahigashicho, Kodaira, Tokyo, 187-0031, Japan.

出版信息

BMC Psychiatry. 2020 Nov 3;20(1):522. doi: 10.1186/s12888-020-02927-z.

Abstract

BACKGROUND

The number of psychiatric care beds and the mean length of stay in psychiatric care beds in Japan have decreased over the past 10 years. However, as has long been indicated here and elsewhere, Japan lags behind other countries in terms of deinstitutionalization. Furthermore, the population of inpatients in psychiatric care beds is aging dramatically. In addition to the diversification of mental illness, the question of what measures to implement going forward regarding current psychiatric bed resources has emerged as a new challenge.

METHODS

Using data from the Patient Survey and the 630 Survey, we examined trends in the number of long-term inpatients in psychiatric care beds in Japan through 2040. Population estimation was used for estimating long-term hospital bed demand because of small fluctuations in the admission and discharge of long-term inpatients.

RESULTS

In 2017, nearly one-third of all long-term hospitalized patients were aged ≥75 years, and an estimated 47% of the total are expected to die by 2040. Thus, the overall demand for long-term hospitalization is forecast to decrease sharply due to aging of currently hospitalized long-term inpatients. The number of long-term inpatients in 2017 was 167,579, and this is projected to decrease to 103,141 in 2040.

CONCLUSIONS

We believe it is necessary to adopt a multifaceted approach to promote hospital discharge and transition to the community, and to address the diversification of mental illness and the issue of psychiatric care bed supply/availability, which are forecast to decrease due to the natural decrease in long-term inpatients.

摘要

背景

在过去的 10 年中,日本的精神科护理床位数量和精神科护理床位的平均住院时间都有所减少。然而,正如这里和其他地方长期以来所指出的那样,日本在去机构化方面落后于其他国家。此外,精神科护理床位住院患者的人口正在迅速老龄化。除了精神疾病的多样化,如何针对当前的精神科床位资源实施未来的措施已成为新的挑战。

方法

我们使用患者调查和 630 调查的数据,通过 2040 年预测日本精神科长期住院患者人数的趋势。由于长期住院患者的入院和出院波动较小,因此使用人口估计来估算长期住院床位的需求。

结果

2017 年,所有长期住院患者中有近三分之一年龄≥75 岁,预计到 2040 年,这一比例将达到 47%。因此,由于目前住院的长期住院患者老龄化,对长期住院的总体需求预计将大幅下降。2017 年长期住院患者人数为 167579 人,预计到 2040 年将减少到 103141 人。

结论

我们认为,有必要采取多方面的方法来促进出院和向社区过渡,并解决精神疾病的多样化和精神科护理床位供应/可用性问题,由于长期住院患者的自然减少,预计这两个问题都会减少。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1e34/7607734/727f812ca072/12888_2020_2927_Fig1_HTML.jpg

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