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与东开普省一家专业精神病医院患者再次入院相关的因素。

Factors associated with patient readmission to a specialised psychiatric hospital in the Eastern Cape.

作者信息

Gaida Razia, Okafor Chinedum, Janse van Vuuren Lichelle, Davids Adlai S

机构信息

Centre for Community Technologies, School of Engineering, Nelson Mandela University, Gqeberha, South Africa.

Eastern Cape Department of Health, Gqeberha, South Africa.

出版信息

S Afr J Psychiatr. 2022 Dec 19;28:1878. doi: 10.4102/sajpsychiatry.v28i0.1878. eCollection 2022.

Abstract

BACKGROUND

Hospital readmissions increase healthcare system costs and can place additional strain on already sparse government funds and under-resourced hospitals. Few studies have investigated readmission of patients in mental health facilities in South Africa.

AIM

The study aimed to identify the factors associated with readmission of patients discharged from an acute psychiatric public hospital in South Africa.

SETTING

The study was conducted at an acute psychiatric public hospital.

METHOD

A retrospective review of medical records was conducted for all patients admitted and readmitted between January 2018 and December 2019.

RESULTS

From the pool of patient records analysed ( = 516), 93 (18.02%) were readmitted, of which the majority (75.27%) were male. The average age of patients readmitted was 27.24 ± 11.16 years, which was significantly younger than the total sample ( < 0.05; CI 1.095-7.105). Findings indicated that patients who completed lower levels of education, were unemployed and were diagnosed with substance (mono- or polysubstance) use disorder ( = 93; 100%), schizophrenia ( = 33; 35.48%), bipolar disorder ( = 9; 9.68%) or intellectual disability ( = 9; 9.68%) were more frequently readmitted, with the average length of stay varying widely between patients.

CONCLUSION

Younger patients and those living with more complex psychiatric conditions, particularly those who are substance abusers, were readmitted more frequently, indicating that these patients may require special consideration for management.

CONTRIBUTION

The study revealed that patients living with complex psychiatric conditions such as schizophrenia and bipolar disorder were readmitted to hospital more frequently, indicating that management of these patients at the community level is challenging.

摘要

背景

医院再入院会增加医疗系统成本,并可能给本就稀缺的政府资金和资源不足的医院带来额外压力。很少有研究调查南非精神卫生机构患者的再入院情况。

目的

本研究旨在确定与南非一家急性精神病公立医院出院患者再入院相关的因素。

地点

本研究在一家急性精神病公立医院进行。

方法

对2018年1月至2019年12月期间所有入院和再入院患者的病历进行回顾性分析。

结果

在分析的患者记录样本(n = 516)中,93例(18.02%)再次入院,其中大多数(75.27%)为男性。再入院患者的平均年龄为27.24 ± 11.16岁,显著低于总样本(p < 0.05;CI 1.095 - 7.105)。研究结果表明,受教育程度较低、失业且被诊断患有物质(单一或多种物质)使用障碍(n = 93;100%)、精神分裂症(n = 33;35.48%)、双相情感障碍(n = 9;9.68%)或智力残疾(n = 9;9.68%)的患者更频繁地再次入院,患者之间的平均住院时间差异很大。

结论

年轻患者和患有更复杂精神疾病的患者,尤其是那些药物滥用者,再入院频率更高,这表明这些患者在管理方面可能需要特殊考虑。

贡献

该研究表明,患有精神分裂症和双相情感障碍等复杂精神疾病的患者更频繁地再次入院,这表明在社区层面管理这些患者具有挑战性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1a04/11465955/51181c33956d/1878-15975-1-PB.jpg

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