Uldall K K, Koutsky L A, Bradshaw D H, Hopkins S G, Katon W, Lafferty W E
Center for AIDS Research, University of Washington School of Medicine, Seattle.
Am J Psychiatry. 1994 Oct;151(10):1475-8. doi: 10.1176/ajp.151.10.1475.
The purpose of this study was to assess the effect of psychiatric comorbidity on specific measures of hospital utilization, including length of stay, among hospitalized AIDS patients.
Data collection involved medical record abstraction for AIDS patients admitted to any one of 19 hospitals in Washington State during 1990. Psychiatric comorbidity was defined by the presence of an ICD-9 code reflecting psychiatric illness. Medical/surgical admissions of AIDS patients with psychiatric diagnoses were compared to those of AIDS patients without psychiatric diagnoses on measures of mean length of stay for the first admission in 1990, total number of hospitalizations in 1990, and total number of hospital days in 1990. Medical morbidity was addressed using CD4+ cell count and current and previous AIDS-defining illnesses as markers of disease severity.
Of 357 patients hospitalized with AIDS, 49 (14%) had at least one psychiatric diagnosis. Patients with psychiatric illness were hospitalized an average of 6.6 days longer than AIDS patients without such illnesses. Differences in medical morbidity did not account for the longer length of stay.
Psychiatric comorbidity increased the average length of stay among hospitalized AIDS patients. Future research needs to address the possible effects of this phenomenon on quality and cost of care received by AIDS patients.
本研究旨在评估精神疾病共病对住院艾滋病患者特定医院利用指标的影响，包括住院时间。
数据收集涉及对1990年在华盛顿州19家医院中任何一家住院的艾滋病患者的病历摘要。精神疾病共病由反映精神疾病的ICD - 9编码确定。将有精神疾病诊断的艾滋病患者的内科/外科住院情况与无精神疾病诊断的艾滋病患者在1990年首次住院的平均住院时间、1990年住院总次数以及1990年住院总天数等指标上进行比较。使用CD4 + 细胞计数以及当前和既往艾滋病定义疾病作为疾病严重程度的标志物来探讨医疗发病率。
在357例艾滋病住院患者中，49例（14%）至少有一项精神疾病诊断。患有精神疾病的患者比没有此类疾病的艾滋病患者平均住院时间长6.6天。医疗发病率的差异并不能解释住院时间延长的原因。
精神疾病共病增加了住院艾滋病患者的平均住院时间。未来的研究需要探讨这一现象对艾滋病患者所接受护理的质量和成本可能产生的影响。
