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种族多元化城市医院环境中青少年精神科再入院的相关因素

Factors Associated With Psychiatric Readmission of Youths in a Racially Diverse and Urban Hospital Setting.

作者信息

Soutullo Olivia R, Duncan Folami, Coleman Lael, Mitchell Stephanie J, Godoy Leandra, Tyson Colby, Long Melissa

机构信息

Children's National Hospital, Washington, D.C. (all authors); Department of Pediatrics (Soutullo, Godoy, Tyson, Long) and Department of Psychiatry and Behavioral Sciences (Soutullo, Godoy, Tyson), School of Medicine and Health Sciences, George Washington University, Washington, D.C.

出版信息

Psychiatr Serv. 2023 Jan 1;74(1):66-69. doi: 10.1176/appi.ps.202100389. Epub 2022 Aug 25.

Abstract

OBJECTIVE

This study examined predictors of readmission to a psychiatric inpatient unit of an urban children's hospital within 1 year of discharge among a racially diverse sample of youths.

METHODS

The authors retrospectively analyzed 2 years of electronic health record data of inpatient psychiatric unit admissions (N=1,604). Multivariate logistic regression and random-effects multinomial logistic regression were used for analyses.

RESULTS

The estimated odds ratios for any readmission within 1 year of discharge were significantly higher for Black youths, youths insured by Medicaid, and youths with a length of stay longer than 7 days. Factors remained strongly predictive when examining multiple readmissions versus no readmissions.

CONCLUSIONS

Black youths, youths insured by Medicaid, and youths with longer stays were more likely than other youths to be readmitted. Findings suggest the need for interventions such as care coordination to target predictors of readmission and the need to examine inequities in the health care system.

摘要

目的

本研究在一个种族多样化的青少年样本中,考察了出院后1年内再次入住一家城市儿童医院精神科住院部的预测因素。

方法

作者回顾性分析了2年的住院精神科病房入院电子健康记录数据(N = 1604)。采用多变量逻辑回归和随机效应多项逻辑回归进行分析。

结果

出院后1年内再次入院的估计比值比,在黑人青少年、由医疗补助计划承保的青少年以及住院时间超过7天的青少年中显著更高。在考察多次再入院与未再入院情况时,这些因素仍具有很强的预测性。

结论

黑人青少年、由医疗补助计划承保的青少年以及住院时间较长的青少年比其他青少年更有可能再次入院。研究结果表明需要采取诸如护理协调等干预措施来针对再入院的预测因素,并且需要审视医疗保健系统中的不公平现象。

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