Hansen T E, Elliott K D
Veterans Affairs Medical Center, Portland, OR 97207.
Hosp Community Psychiatry. 1993 Apr;44(4):372-5. doi: 10.1176/ps.44.4.372.
The study examined characteristics of patients who made repeat visits to the psychiatric emergency service of a Veterans Affairs medical center.
Computer records of patients who visited the emergency service were retrospectively examined for a one-year period after their index visit. Patients were divided into three groups according to the number of visits; nonrepeaters had only one visit, occasional repeaters had two or three visits, and frequent repeaters had four or more visits.
Of 1,144 patients who visited the emergency service during the one-year study period, 26 percent were occasional repeaters and 8 percent were frequent repeaters; the latter group accounted for 24 percent of all visits. Schizophrenic patients were overrepresented among frequent repeaters. Compared with nonrepeaters, repeat visitors were admitted to the hospital more often and were less likely to be referred to an outpatient clinic for follow-up. Frequent repeaters were more likely than occasional repeaters to revisit within one month and to visit during evening hours.
One-third of patients seen during a one-year period revisited the emergency service, a rate substantially higher than those reported for large urban non-VA hospitals. The higher rate may have been due to the longer sampling period, to a more seriously ill population, or to fewer community resources for veterans because of misperceptions about their eligibility.
本研究调查了前往退伍军人事务医疗中心精神科急诊室复诊患者的特征。
对急诊室就诊患者的计算机记录进行回顾性检查，时间跨度为首次就诊后的一年。根据就诊次数将患者分为三组；非复诊者仅就诊一次，偶尔复诊者就诊两到三次，频繁复诊者就诊四次或更多次。
在为期一年的研究期间前往急诊室就诊的1144名患者中，26%为偶尔复诊者，8%为频繁复诊者；后者占所有就诊次数的24%。频繁复诊者中精神分裂症患者比例过高。与非复诊者相比，复诊患者住院的可能性更高，被转至门诊进行随访的可能性更低。频繁复诊者比偶尔复诊者更有可能在一个月内再次就诊，且更有可能在夜间就诊。
在一年期间就诊的患者中有三分之一再次前往急诊室，这一比例大大高于大型城市非退伍军人事务医院报告的比例。较高的比例可能是由于抽样期更长、患者病情更严重，或者由于对退伍军人资格的误解导致退伍军人可利用的社区资源较少。
