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2001 年至 2013 年巴西住院患者队列中早期和频繁的精神科再入院。

Early and Frequent Psychiatric Readmissions in a Brazilian Cohort of Hospitalized Patients Between 2001 and 2013.

机构信息

Faculdade de Medicina. Programa de Pós- Graduação em Saúde Pública. Belo Horizonte, Universidade Federal de Minas Gerais, Minas Gerais, Brasil.

Instituto de Ciências Exatas. Departamento de Estatística. Belo Horizonte, Universidade Federal de Minas Gerais, Minas Gerais, Brasil.

出版信息

Adm Policy Ment Health. 2024 Mar;51(2):147-161. doi: 10.1007/s10488-023-01322-6. Epub 2023 Nov 16.

Abstract

OBJECTIVE

To characterize the profile of patients who were readmitted for mental and behavioral disorders, in the Brazilian Unified Health System, from 2001 to 2014, and the factors associated with early and frequent readmission.

METHOD

A retrospective, non-concurrent cohort study of patients admitted with a primary diagnosis of mental or behavioral disorders, from 2001 to 2014. This study selected demographic variables and clinical variables, as well as variables related to the characteristics of the hospitals. Poisson Regression methods with a robust variance estimator were used to estimate the incidence rate ratio (IRR) for each of the outcomes.

RESULTS

Early readmission occurred for 6.8% of the patients and frequent readmission for 8.3%. Characteristics such as being male, younger, with a diagnosis of a bipolar disorder, and admitted to a specialized hospital show a higher IRR for early readmission. The occurrence of early readmission was the most heavily associated characteristic with an increased rate of early readmission, and the magnitude of this increase depends on the patient's age.

CONCLUSION

Early and frequent readmissions are linked to patients' demographics, clinical information and health system's organization. Early readmission should be a priority in treatment planning to prevent frequent readmissions due to its strong association.

摘要

目的

描述 2001 年至 2014 年期间,在巴西统一卫生系统中因精神和行为障碍再次入院的患者特征,以及与早期和频繁再入院相关的因素。

方法

这是一项回顾性、非同期队列研究,纳入了 2001 年至 2014 年期间因主要诊断为精神或行为障碍而入院的患者。本研究选择了人口统计学变量和临床变量,以及与医院特征相关的变量。使用具有稳健方差估计的泊松回归方法估计每个结局的发生率比(IRR)。

结果

6.8%的患者发生早期再入院,8.3%的患者发生频繁再入院。男性、年龄较小、双相情感障碍诊断以及入住专科医院等特征与早期再入院的更高 IRR 相关。早期再入院的发生与增加早期再入院的发生率密切相关,其增加幅度取决于患者的年龄。

结论

早期和频繁的再入院与患者的人口统计学、临床信息和卫生系统组织有关。早期再入院应成为治疗计划的重点,以防止因强烈关联而导致频繁再入院。

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