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希腊非自愿住院患者的住院时间:一项 10 年回顾性观察研究。

Length of hospital stay in involuntary admissions in Greece: a 10-year retrospective observational study.

机构信息

Department of Public Health, Medical School, University of Patras, Rio, 26500, Patras, Greece.

Mobile Mental Health Unit of the Prefectures of Ioannina and Thesprotia, Society for the Promotion of Mental Health in Epirus, Ioannina, Greece.

出版信息

Soc Psychiatry Psychiatr Epidemiol. 2024 Oct;59(10):1861-1870. doi: 10.1007/s00127-024-02653-x. Epub 2024 Apr 29.

Abstract

PURPOSE

The treatment of mental disorders has shifted from inpatient wards to community-based settings in recent years, but some patients may still have to be admitted to inpatient wards, sometimes involuntarily. It is important to maintain the length of hospital stay (LoS) as short as possible while still providing adequate care. The present study aimed to explore the factors associated with the LoS in involuntarily admitted psychiatric patients.

METHODS

A ten-year retrospective chart review of 332 patients admitted involuntarily to the inpatient psychiatric ward of the General University Hospital of Ioannina, Northwestern Greece, between 2008 and 2017 was conducted.

RESULTS

The mean LoS was 23.8 (SD = 33.7) days and was relatively stable over the years. Longer-stay hospitalization was associated with schizophrenia-spectrum disorder diagnosis, previous hospitalizations and the use of mechanical restraint, whereas patients in residential care experienced significantly longer LoS (52.6 days) than those living with a caregiver (23.5 days) or alone (19.4 days). Older age at disease onset was associated with shorter LoS, whereas no statistically significant differences were observed with regard to gender.

CONCLUSION

While some of our findings were in line with recent findings from other countries, others could not be replicated. It seems that multiple factors influence LoS and the identification of these factors could help clinicians and policy makers to design more targeted and cost-effective interventions. The optimization of LoS in involuntary admissions could improve patients' outcomes and lead to more efficient use of resources.

摘要

目的

近年来,精神障碍的治疗已经从住院病房转移到了基于社区的环境,但仍有一些患者可能需要住院治疗,有时甚至是强制性的。在提供充分护理的同时,尽可能缩短住院时间(LoS)非常重要。本研究旨在探讨与强制性住院精神科患者 LOS 相关的因素。

方法

对 2008 年至 2017 年期间在希腊西北部约阿尼纳大学综合医院住院精神科强制性住院的 332 名患者进行了为期十年的回顾性图表审查。

结果

平均 LOS 为 23.8(SD=33.7)天,且多年来相对稳定。较长的住院时间与精神分裂症谱系障碍诊断、既往住院和使用机械约束有关,而居住在养老院的患者的 LOS(52.6 天)明显长于与照顾者一起生活的患者(23.5 天)或独自生活的患者(19.4 天)。发病年龄较大与 LOS 较短有关,而性别方面无统计学差异。

结论

虽然我们的一些发现与其他国家最近的发现一致,但其他发现无法复制。似乎有多种因素影响 LOS,识别这些因素可以帮助临床医生和政策制定者设计更有针对性和更具成本效益的干预措施。优化强制性住院的 LOS 可以改善患者的预后,并更有效地利用资源。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3b75/11464606/2f4478c5ab9a/127_2024_2653_Fig1_HTML.jpg

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