Gold J, Shera D, Clarkson B
Westwood Lodge Hospital, MA.
J Am Acad Child Adolesc Psychiatry. 1993 Jan;32(1):135-43. doi: 10.1097/00004583-199301000-00020.
To quantitatively identify predictors and determinants of length of psychiatric hospital stay for children.
Forty-seven demographic, psychosocial stressor, psychopathology, and disposition variables were statistically reviewed as correlates of length of stay in 100 consecutive discharges from a child psychiatry inpatient service (age range 4-12) in a private hospital. Those with strong statistical significance were then analyzed by multiple regression.
Greater severity of psychopathology (measured by the Children's Global Assessment Scale), greater severity of psychosocial stressors (by Axis IV scale), diagnosis of post-traumatic stress disorder, special educational and out-of-home dispositions, and severe tantrums in hospital all strongly predicted longer hospital stay. Diagnosis of adjustment disorder predicted shorter stay. Together these variables explained 57% of the total variance in length of stay.
The most powerful of these predictor variables could potentially be measured at the time of admission, thus permitting accurate prediction of length of stay. A set of models was generated for this purpose.
定量识别儿童精神科住院时间的预测因素和决定因素。
对47个人口统计学、心理社会应激源、精神病理学和处置变量进行统计学审查,将其作为一家私立医院儿童精神科住院部连续100例出院病例(年龄范围4至12岁)住院时间的相关因素。然后对具有强统计学意义的变量进行多元回归分析。
精神病理学严重程度更高(通过儿童总体评估量表衡量)、心理社会应激源严重程度更高(通过轴IV量表衡量)、创伤后应激障碍诊断、特殊教育和院外处置情况以及住院期间严重发脾气,均强烈预测住院时间更长。适应障碍诊断预测住院时间更短。这些变量共同解释了住院时间总方差的57%。
这些预测变量中最有力的变量可能在入院时即可测量,从而能够准确预测住院时间。为此生成了一组模型。