Lyons J S, O'Mahoney M T, Miller S I, Neme J, Kabat J, Miller F
Department of Psychiatry and Behavioral Sciences, Northwestern University Medical School, Chicago, IL 60611-3008, USA.
Am J Psychiatry. 1997 Mar;154(3):337-40. doi: 10.1176/ajp.154.3.337.
This study examined predictors of hospital readmission to determine whether readmissions can serve as a quality indicator for an inpatient psychiatric service.
A series of 255 patients consecutively admitted to any of seven psychiatric hospitals in a regional managed care program were followed to determine whether they were readmitted within 6 months of discharge. Case managers assessed patients with the use of a reliable outcome management/decision support system designed for acute psychiatric services.
Patients with greater impairment in self-care, more severe symptoms, and more persistent illnesses were more likely to be readmitted than other patients. Suicidal patients were less likely to be readmitted. There was no evidence to suggest that poor hospital outcome or premature discharge was associated with readmission either within 30 days or within 6 months.
Although patients at risk for hospital admission can be identified, it does not appear that the success of the hospital intervention per se influences the likelihood of readmission. Use of readmission rates as quality indicators for hospital care providers is not recommended.
本研究对再入院的预测因素进行了调查，以确定再入院情况能否作为住院精神科服务的质量指标。
对在一个区域管理式医疗项目中连续入住七家精神病医院中任何一家的255名患者进行跟踪，以确定他们在出院后6个月内是否再次入院。个案管理员使用为急性精神科服务设计的可靠的结果管理/决策支持系统对患者进行评估。
自理能力受损更严重、症状更严重、疾病更持久的患者比其他患者更有可能再次入院。有自杀倾向的患者再次入院的可能性较小。没有证据表明在30天内或6个月内，住院效果不佳或过早出院与再次入院有关。
虽然可以识别有入院风险的患者，但医院干预本身的成功似乎并不会影响再次入院的可能性。不建议将再入院率用作医院护理提供者的质量指标。
