Section of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Psychosis Department, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden.
Nord J Psychiatry. 2023 Aug;77(6):600-607. doi: 10.1080/08039488.2023.2199726. Epub 2023 Apr 21.
Patients with psychotic disorders often need hospitalization with long stays. Person-centered care (PCC) has been shown to improve care quality and decrease the length of hospital stay in non-psychiatric settings. We carried out an educational intervention for inpatient staff, aiming to increase person-centeredness at a major Swedish psychosis clinic. The aim of this study was to test if the intervention could be associated with decreased length of hospital stay (LoS), involuntary stay (LoIS), and reduction in rapid readmissions.
Data from the clinic's administrative registry were compared for patients with a discharge diagnosis within the schizophrenia-spectrum treated during the one-year periods before and after the PCC intervention.
Contrary to our hypotheses, a quantile regression estimated longer LoS post-intervention, median difference 10.4 d (CI 4.73-16.10). Neither age, sex nor diagnostic category were associated with LoS. Of all inpatient days, ∼80% were involuntary. While LoIS was numerically longer post-intervention, the difference did not reach significance in the final regression model (median difference 7.95 d, CI -1.40 to 17.31). Proportions with readmission within 2 weeks of discharge did not differ (7.7% vs 5.2%, n.s.).
Increased length of inpatient care was observed after the PCPC intervention. This could reflect an increased focus on the unmet needs of persons with serious psychotic conditions, but it needs to be explored in future research using a more rigorous study design.
This study is part of a larger evaluation of Person-Centered Psychosis Care (PCPC), registered during data collection (after the study start, before analysis) at clinicaltrials.gov, identifier NCT03182283.
患有精神病的患者通常需要住院治疗，且住院时间较长。以患者为中心的护理（PCC）已被证明可提高护理质量并缩短非精神病环境中的住院时间。我们对住院工作人员进行了教育干预，旨在提高瑞典一家主要精神病诊所的以患者为中心程度。本研究的目的是检验干预措施是否与住院时间（LoS）缩短、非自愿住院（LoIS）减少和快速再入院减少相关。
对在 PCC 干预前后一年期间接受精神分裂症谱系障碍治疗的门诊患者的诊所行政登记数据进行比较。
与我们的假设相反，分位数回归估计干预后LoS 延长，中位数差异为 10.4d（CI 4.73-16.10）。年龄、性别和诊断类别均与 LoS 无关。所有住院天数中，约 80%为非自愿住院。虽然干预后 LoIS 略有延长，但最终回归模型中差异无统计学意义（中位数差异 7.95d，CI -1.40 至 17.31）。出院后 2 周内再入院的比例没有差异（7.7% vs 5.2%，n.s.）。
在 PCPC 干预后观察到住院治疗时间延长。这可能反映了对严重精神病患者未满足需求的关注增加，但需要在未来研究中使用更严格的研究设计进行探索。
这项研究是更大规模的“以人为中心的精神病护理”（PCPC）评估的一部分，在数据收集期间（在研究开始后、分析前）在 clinicaltrials.gov 上注册，标识符为 NCT03182283。
