Psychiatric Admissions and Length of Stay During Fiscal Years 2014 and 2015 in Japan: A Retrospective Cohort Study Using a Nationwide Claims Database.
Psychiatric Admissions and Length of Stay During Fiscal Years 2014 and 2015 in Japan: A Retrospective Cohort Study Using a Nationwide Claims Database.
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DOI：
10.2188/jea.je20180096
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发表时间：
2019-08-05
影响因子：
4.7
通讯作者：
Tachimori H
中科院分区：
文献类型：
--
作者：
Okumura Y;Sugiyama N;Noda T;Tachimori H
更好地了解新精神病患者入院的资源使用情况对于医疗保健提供者和政策制定者改善精神病护理非常重要。本研究旨在描述新的精神病入院模式和在日本的住院时间。使用日本健康保险索赔和特定健康检查国家数据库 (NDB) 的数据进行了一项回顾性队列研究。 2014年4月至2016年3月期间新入住精神科病房的所有患者均被纳入并进行随访，直至出院回到社区。我们的样本包括 2 年内来自 1,621 家医院的 605,982 例入院病例。 2014财年月平均入学人数为25,024人，2015财年为25,475人。入学人数存在季节性趋势，夏季（7月）为高峰。 90天和360天内的出院率分别为64.1%和85.7%，不同住院费用类型和医院有所不同。例如，精神科急诊科 90 天内的医院出院率范围在第一（最低）五分位数中为 46.0-75.3%，而在第五（最高）五分位数中为 83.6-96.0%。新开发银行地市级指标与630调查的相关性>0.70。我们的研究提供了日本新入院精神病患者资源使用的基本信息。尽管使用新开发银行在监测资源使用方面有很大好处，但由于数据库固有的方法问题，应谨慎解释结果。
A better understanding of resource use of new psychiatric admissions is important for healthcare providers and policymakers to improve psychiatric care. This study aims to describe the pattern of new psychiatric admissions and length of stay in Japan. A retrospective cohort study was conducted using data from the National Database of Health Insurance Claims and Specific Health Checkups of Japan (NDB). All patients newly admitted to psychiatric wards from April 2014 through March 2016 were included and followed up until discharge to the community. Our sample included 605,982 admissions from 1,621 hospitals over 2 years. The average monthly number of admissions was 25,024 in fiscal year 2014 and 25,475 in fiscal year 2015. There was a seasonal trend in the number of admissions, with a peak in summer (in July). The discharge rates within 90 days and 360 days were 64.1% and 85.7%, respectively, and varied by type of hospital fee and by hospital. For example, the range of hospital-level discharge rate within 90 days in psychiatric emergency units was 46.0–75.3% in the 1st (lowest) quintile, while it was 83.6–96.0% in the 5th (highest) quintile. The prefecture-level indicators in the NDB and the 630 survey had correlations of >0.70. Our study provides fundamental information on resource use of new psychiatric admissions in Japan. Although using the NDB has substantial benefits in monitoring resource use, the results should be interpreted with some caution owing to methodological issues inherent in the database.