Shields Morgan C, Hollander Mara A G, Busch Alisa B, Kantawala Zohra, Rosenthal Meredith B
Brown School, Washington University in St. Louis, St. Louis, MO 63130, United States.
Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, NC 28223, United States.
Health Aff Sch. 2023 Jun 20;1(1):qxad017. doi: 10.1093/haschl/qxad017. eCollection 2023 Jul.
Following discharge from inpatient psychiatry, patients experience elevated suicide risk, unplanned readmission, and lack of outpatient follow-up visits. These negative outcomes might relate to patient-centered care (PCC) experiences while hospitalized. We surveyed 739 former patients of inpatient psychiatric settings to understand the relationship between PCC and changes in patients' trust, willingness to engage in care, and self-reported 30-day follow-up visits. We also linked PCC measures to facility-level quality measures in the Inpatient Psychiatric Facility Quality Reporting program. Relative to patients discharged from facilities in the top quartile of PCC, those discharged from facilities in the bottom quartile were more likely to experience reduced trust (predicted probability [PP] = 0.77 vs 0.46; < .001), reduced willingness to go to the hospital voluntarily (PP = 0.99 vs 0.01; < .001), and a lower likelihood of a 30-day follow-up (PP = 0.71 vs 0.92; < .001). PCC was lower among patients discharged from for-profits, was positively associated with facility-level quality measures of 7- and 30-day follow-up and medication continuation, and was inversely associated with restraint use. Findings underscore the need to introduce systematic measurement and improvement of PCC in this setting.
从住院精神病科出院后,患者面临自杀风险升高、意外再次入院以及缺乏门诊随访等问题。这些负面结果可能与住院期间以患者为中心的护理(PCC)体验有关。我们对739名住院精神病科的 former patients进行了调查,以了解PCC与患者信任度变化、接受护理的意愿以及自我报告的30天随访之间的关系。我们还将PCC指标与住院精神病科质量报告计划中的机构层面质量指标相关联。与从PCC处于前四分位数的机构出院的患者相比,从处于后四分位数的机构出院的患者更有可能经历信任度降低(预测概率[PP]=0.77对0.46;<.001)、自愿去医院的意愿降低(PP=0.99对0.01;<.001)以及30天随访的可能性降低(PP=0.71对0.92;<.001)。营利性机构出院的患者的PCC较低,与7天和30天随访以及药物持续治疗的机构层面质量指标呈正相关,与约束使用呈负相关。研究结果强调了在这种情况下引入PCC的系统测量和改进的必要性。
原文中“former patients”直译为“以前的患者”,结合语境这里可能是“出院患者”,但按照要求未做修改。