Psychiatric co-morbidity and hospital utilization in the general medical sector.
Psychiatric co-morbidity and hospital utilization in the general medical sector.
复制标题
精神科共病和普通医疗部门的医院利用率。
DOI：
10.1017/s0033291798008071
复制
发表时间：
1999
影响因子：
6.9
通讯作者：
Savoca,E
中科院分区：
文献类型：
--
作者：
Savoca,E
背景。本文通过对美国人口进行广泛的调查，提供了关于精神疾病、身体疾病和普通医疗部门医院使用之间关系的证据。方法。数据来自1989年全国健康访谈调查。该调查包含整个样本的医疗和心理健康评估。在多变量框架中，作者估计了精神疾病对入住综合医院的概率、入院次数和住院时间的影响。结果。患有身体和精神疾病的人在一般医疗部门的医院使用率明显高于没有精神疾病的人。对于多种医疗状况，当身体疾病伴有精神疾病时，预计入院人数和住院时间会大幅增加。结论。这一发现的一个含义是，对替代精神科治疗的经济评估应考虑与治疗共存疾病相关的住院费用的任何差异。另一个影响与医疗保健系统有关，保险公司对为哪些个人提供保险有一定的自由裁量权。如果没有对高风险潜在参保者的保险支付进行适当调整，精神残疾人获得健康保险的机会可能会更加有限。
Background. This article provides evidence about the relationship between psychiatric disorders, physical disorders and hospital use in the general medical sector using a broadly based survey of the US population.Methods. The data are from the 1989 National Health Interview Survey. This survey contains medical and mental health evaluations for the entire sample. In a multivariate framework, the author estimates the effect of mental illness on the probability of being admitted to a general hospital, the number of admissions and the length of stay.Results. Hospital use in the general medical sector is significantly higher for persons with coexisting physical and psychiatric conditions than for those with no psychiatric disorders. For a wide range of medical conditions, the predicted number of hospital admissions and the length of a hospital stay increase substantially when the physical illness is accompanied by a psychiatric condition.Conclusions. One implication of this finding is that economic evaluations of alternative psychiatric treatments should consider any differences in hospital costs related to the treatment of coexisting medical conditions. Another implication pertains to health care systems where insurers have some discretion over which individuals to insure. In the absence of adequate adjustments in insurance payments for high-risk potential enrollees, psychiatrically disabled persons may have more limited access to health insurance.