Băcilă Ciprian, Ștef Laura, Bucuță Mihaela, Anghel Claudia Elena, Neamțu Bogdan, Boicean Adrian, Mohor Cosmin, Ștețiu Andreea Angela, Roman Mihai
Dental and Nursing Medical Department, Faculty of Medicine, "Lucian Blaga" University of Sibiu, 550169 Sibiu, Romania.
Collective of Scientific Research in Neurosciences of the Clinical Psychiatry Hospital "Dr. Gheorghe Preda", 550082 Sibiu, Romania.
Healthcare (Basel). 2023 Apr 30;11(9):1291. doi: 10.3390/healthcare11091291.
The COVID-19 pandemic brought a burden and represented a challenge for the Romanian medical system. This study explored the consequences that COVID epidemiological measures had on the quality of the mental health care provided to hospitalized patients in a regional psychiatric hospital in Romania.
Both patient-level and hospital-level indicators were considered for this comparative retrospective study. On the one hand, we extracted patient-level indicators, such as sociodemographics, diagnosis, admission, and discharge dates for 7026 hospitalized patients (3701 women, average age = 55.14) from hospital records. On the other hand, for the hospital-level indicators, we included indicators referring to the aggregated concept of mental health services, such as case mix index, length of stay, bed occupancy rate and patients' degree of satisfaction. Data extracted covered a period of two years (1 March 2019-28 February 2021) before and during the first year of the COVID-19 pandemic.
We found that, compared to the pre-pandemic period, the pandemic period was marked by a drastic decrease in hospitalized patient admissions, coupled with an increase in emergency-based admissions. Other management indicators, such as the case mix index, the number of cases contracted/performed, and the degree of patient satisfaction, decreased. In contrast, the average length of stay and bed occupancy rate increased.
The COVID-19 pandemic, especially in the first year, raised multiple difficult issues for the management of psychiatric hospitals. It imposed an application of strict measures designed to face these new and unprecedented challenges. Our findings offer a detailed snapshot of the first year of the COVID-19 pandemic in terms of its impact on mental health services and suggest some future directions. Implications for hospital management are discussed.
新冠疫情给罗马尼亚医疗系统带来了负担并构成了挑战。本研究探讨了新冠疫情防控措施对罗马尼亚一家地区精神病医院为住院患者提供的精神卫生保健质量所产生的影响。
本比较性回顾研究考虑了患者层面和医院层面的指标。一方面，我们从医院记录中提取了7026名住院患者（3701名女性，平均年龄 = 55.14岁）的患者层面指标，如社会人口统计学特征、诊断、入院和出院日期。另一方面，对于医院层面的指标，我们纳入了涉及精神卫生服务总体概念的指标，如病例组合指数、住院时间、床位占用率和患者满意度。提取的数据涵盖了新冠疫情第一年之前及期间的两年时间（2019年3月1日至2021年2月28日）。
我们发现，与疫情前时期相比，疫情期间住院患者入院人数急剧下降，同时基于急诊的入院人数增加。其他管理指标，如病例组合指数、收治/开展的病例数以及患者满意度均有所下降。相比之下，平均住院时间和床位占用率有所上升。
新冠疫情，尤其是在第一年，给精神病医院的管理带来了诸多难题。它迫使实施严格措施以应对这些新的、前所未有的挑战。我们的研究结果详细呈现了新冠疫情第一年对精神卫生服务的影响，并提出了一些未来方向。文中还讨论了对医院管理的启示。
