Identifying modifiable risk factors for rehospitalization: a case-control study of seriously mentally ill persons in Mississippi.
Identifying modifiable risk factors for rehospitalization: a case-control study of seriously mentally ill persons in Mississippi.
复制标题
确定再住院的可改变风险因素：密西西比州严重精神病患者的病例对照研究。
DOI：
10.1176/ajp.152.12.1749
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发表时间：
1995
期刊：
影响因子：
--
通讯作者：
Leake,B
中科院分区：
文献类型：
--
作者：
Sullivan,G;Wells,KB;Morgenstern,H;Leake,B
目的作者试图确定严重精神疾病人群再住院的危险因素，重点关注那些有可能通过社区干预措施加以改变的因素。方法采用病例对照设计，其中 101 名“病例”受试者（最近重新入院的精神病患者）和 101 名生活在社区的受试者（之前与病例受试者同时入院，但没有重新入院）在性别、种族、种族等方面进行匹配。以及再住院风险的时间长度。背景是 1988 年前 3 个月的密西西比州公共精神卫生系统，包括密西西比州立医院及其辖区的 10 个社区精神卫生区域。受试者年龄在 18 至 55 岁之间，之前至少入院过一次密西西比州立医院，并且有精神分裂症的初步诊断；该研究还包括 197 名知情人，其中大部分是家庭成员。数据收集自受试者和知情人的结构化访谈、受试者的直接观察评级、密西西比州立医院的管理记录和社区精神卫生中心的管理记录。结果不服药、合并酗酒以及知情人对受试者的高度批评与再住院风险较高相关，而门诊服务使用的类型和程度、获得护理的机会、生活质量和人口变量（种族和性别除外）则不然。结论这些发现表明，旨在提高用药依从性、减少酗酒以及帮助家庭应对患有精神疾病的亲属的干预措施可以降低该人群住院的风险。
ObjectiveThe authors sought to identify risk factors for rehospitalization in a seriously mentally ill population, focusing on factors that have the potential to be modified through community-based interventions.MethodA case-control design was used in which 101" case" subjects (recently readmitted psychiatric patients) and a comparison group of 101 subjects living in the community who had been previously hospitalized at the same time as the case subjects, but who in contrast had not been readmitted, were matched on gender, ethnicity, and length of time at risk for rehospitalization. The setting was the Mississippi public mental health system during the first 3 months of 1988, including Mississippi State Hospital and the 10 community mental health regions in its catchment area. The subjects were between the ages of 18 and 55 years, had had at least one previous Mississippi State Hospital admission, and had a primary chart diagnosis of schizophrenia; 197 informants, mostly family members, were also included in the study. Data were collected from structured interviews of subjects and informants, direct observation ratings of subjects, Mississippi State Hospital administrative records, and community mental health center administrative records.ResultsMedication noncompliance, comorbid alcohol abuse, and a high level of criticism of subjects by informants were associated with greater risk of rehospitalization, while types and extent of outpatient service use, access to care, quality of life, and demographic variables (other than ethnicity and gender) were not.ConclusionsThese findings imply that interventions aimed at improving medication compliance, reducing alcohol abuse, and helping families cope with their mentally ill relatives could reduce the risk of hospitalization in this population.