Association between length of hospital stay and implementation of discharge planning in acute psychiatric inpatients in Japan.
Association between length of hospital stay and implementation of discharge planning in acute psychiatric inpatients in Japan.
复制标题
DOI：
10.1186/s13033-015-0015-9
复制
发表时间：
2015
影响因子：
3.6
通讯作者：
Asukai N
中科院分区：
文献类型：
--
作者：
Nakanishi M;Niimura J;Tanoue M;Yamamura M;Hirata T;Asukai N
日本已在公共医疗保险计划中引入了急性精神病护理单元，但其要求住院时间较短，可能导致在没有适当出院计划的情况下出院。本研究旨在探讨日本急性精神病住院患者出院计划的实施与住院时间之间的关系。这项回顾性横断面研究包括2011年3月7日至20日两周内从66家医院的“精神科急诊病房”出院的449名患者。每例患者的指定护士或护理助理提供了住院期间出院计划实施的信息。约四分之一的449例患者（n = 122）没有得到支持出院后的社区护理资源的协调。与其他327例患者相比，122例未接受社区护理协调支持的患者入院时的平均年龄显著较低，住院时间较短，无随访或出院后门诊服务不明的比例较高。多水平线性回归分析显示，年龄较大的患者，那些谁有精神分裂症的初步诊断，那些谁被强制承认，那些谁接受医院门诊服务，和那些谁接受社区护理协调支持分配的护士或护理助理之间的住院时间显着更长。社区护理协调支持的实施并没有表明与这些因素有显着的关联，这些因素与精神病再入院的风险增加有关。由指定的护士或护理助理提供社区护理协调支持的患者住院时间显著延长。社区护理协调支持的实施并没有表明与这些因素有显着的关联，这些因素与精神病再入院的风险增加有关。精神卫生政策应更加注重急性精神病患者的出院规划，以加强精神病住院治疗和出院后社区护理资源之间的联系。
Japan has introduced an acute psychiatric care unit to the public healthcare insurance program, but its requirement of a shorter length of stay could lead to discharges without proper discharge planning. The aim of this study was to examine the association between the implementation of discharge planning and the length of stay of acute psychiatric inpatients in Japan. This retrospective cross-sectional study included 449 patients discharged from the ‘psychiatric emergency ward’ of 66 hospitals during a two-week period from March 7 to 20, 2011. The assigned nurse or nursing assistant for each patient provided information on the implementation of discharge planning in the hospital stay. Approximately one quarter of the 449 patients (n = 122) received no support for coordination with post-discharge community care resources. The 122 patients who had received no support for community care coordination had a significantly lower mean age at admission, a shorter length of stay, and a higher rate of either no follow-up or unidentified post-discharge outpatient service than the other 327 patients. Multilevel linear regression analysis demonstrated a significantly greater length of stay among patients who were older, those who had a primary diagnosis of schizophrenia, those who were admitted compulsorily, those who received hospital outpatient services, and those who received community care coordination support from the assigned nurse or nursing assistant. The implementation of support for community care coordination did not indicate a significant association with these factors, which have been related to an increased risk of psychiatric readmission. Patients to whom the assigned nurse or nursing assistant provided support on community care coordination experienced a significantly greater length of hospital stay. The implementation of support for community care coordination did not indicate a significant association with these factors, which have been related to an increased risk of psychiatric readmission. The mental health policy should increase focus on discharge planning in the acute psychiatric setting to enhance a link between psychiatric inpatient care and post-discharge community care resources.
登录
查看更多内容
影响因子：
3.5
作者：
Compton, Michael T.;Craw, Jason;Rudisch, Bruce E.
通讯作者：
Rudisch, Bruce E.
DOI：
10.1111/j.1365-2850.2004.00692.x
发表时间：
2004-02-01
影响因子：
2.7
作者：
Reynolds, W;Lauder, W;Cameron, D
通讯作者：
Cameron, D
影响因子：
3.7
作者：
Xafenias, Athanasios;Diakogiannis, Ioannis;Kaprinis, Georgios
通讯作者：
Kaprinis, Georgios
影响因子：
3.8
作者：
Graca, Joao;Klut, Catarina;Cardoso, Graca
通讯作者：
Cardoso, Graca
影响因子：
4.4
作者：
Pertile, Riccardo;Donisi, Valeria;Amaddeo, Francesco
通讯作者：
Amaddeo, Francesco