Finanzas Empresariales, Universitat de València, Valencia, Spain.
AMADEM, Alicante, Spain.
Ann Med. 2022 Dec;54(1):858-866. doi: 10.1080/07853890.2022.2048884.
The goal of this study is to analyse hospital costs and length of stay of patients admitted to psychiatric units in hospitals in a European region of the Mediterranean Arc. The aim is to identify the effects of comorbidities and other variables in order to create an explanatory cost model.
In order to carry out the study, the Ministry of Health was asked to provide data on access to the mental health facilities of all hospitals in the region. Among other questions, this database identifies the most important diagnostic variables related to admission, like comorbidities, age and gender. The method used, based on the Manning-Mullahy algorithm, was linear regression. The results were measured by the statistical significance of the independent variables to determine which of them were valid to explain the cost of hospitalization.
Psychiatric inpatients can be divided into three main groups (psychotic, organic and neurotic), which have statistically significant differences in costs. The independent variables that were statistically significant ( <.05) and their respective beta and confidence intervals were: psychotic group (19,833.0 ± 317.3), organic group (9,878.4 ± 276.6), neurotic group (11,060.1 ± 287.6), circulatory system diseases (19,170 ± 517.6), injuries and poisoning (21,101.6 ± 738.7), substance abuse (20,580.6 ± 514, 6) and readmission (19,150.9 ± 555.4).
Unlike most health services, access to psychiatric facilities does not correlate with comorbidities due to the specific nature of this specialization. Patients admitted to psychosis had higher costs and a higher number of average staysKEY MESSAGESThe highest average hospital expenditure occurred in patients admitted for psychotic disorders.Due to the particularities of psychiatry units and unlike other medical specialties, the number of comorbidities did not influence the number of hospital stays or hospital expenditure.Apart from the main diagnostic group, the variables that were useful to explain hospital expenditure were the presence of poisoning and injuries as comorbidity, diseases of circulatory system as comorbidity, history of substance abuse and readmission.
本研究旨在分析地中海弧形区域内一家医院精神科病房的住院患者的住院费用和住院时间。目的是确定合并症等变量的影响，以建立一个解释性成本模型。
为了开展研究，卫生部被要求提供该地区所有医院精神卫生机构就诊数据。除其他问题外，该数据库还确定了与入院相关的最重要诊断变量，如合并症、年龄和性别。使用的方法是基于曼宁-马洛伊算法的线性回归。结果通过独立变量的统计显著性来衡量，以确定哪些变量可以有效地解释住院费用。
精神科住院患者可分为三个主要组（精神病性、器质性和神经症性），这三组在费用上有统计学显著差异。具有统计学显著性（ <.05）的独立变量及其各自的β和置信区间分别为：精神病性组（19833.0 ± 317.3）、器质性组（9878.4 ± 276.6）、神经症性组（11060.1 ± 287.6）、循环系统疾病（19170 ± 517.6）、损伤和中毒（21101.6 ± 738.7）、物质滥用（20580.6 ± 514.6）和再入院（19150.9 ± 555.4）。
与大多数卫生服务不同，由于该专业的特殊性，获得精神科治疗与合并症无关。因精神病入院的患者费用更高，平均住院时间更长。
精神病住院患者的平均住院费用最高。由于精神科病房的特殊性，与其他医学专业不同，合并症数量并未影响住院时间或住院费用。除主要诊断组外，对解释住院费用有用的变量是合并中毒和损伤、循环系统疾病作为合并症、物质滥用史和再入院。
