Factors affecting prolonged length of stay in psychiatric patients in Japan: A retrospective observational study
Factors affecting prolonged length of stay in psychiatric patients in Japan: A retrospective observational study
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DOI：
10.1111/pcn.12521
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发表时间：
2017-08-01
影响因子：
11.9
通讯作者：
Fushimi, Kiyohide
中科院分区：
文献类型：
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作者：
Shinjo, Daisuke;Tachimori, Hisateru;Fushimi, Kiyohide
目的：住院时间（LOS）是医疗效率的分层指标之一，通常用于评估精神科护理的绩效。本研究的目的是确定长期LOS的精神病patients.Methods的危险因素：我们回顾性分析成人精神病患者（ICD-10; F00-F99）2012年4月至2014年3月在日本诊断程序组合数据库。我们使用多变量逻辑回归分析来研究影响LOS延长的因素。结果：共纳入34326例精神科住院患者，其中精神科住院患者100例，精神科住院患者100例，精神科出院患者100例，精神科住院患者100例，精神科出院患者100例，精神科住院患者100例，精神科出院患者100例。年龄较大、较低的总体功能评估评分、非自愿承诺、几种精神科服务、某些其他患者因素、学术医院、公立医院和较高密度的精神科床位与延长的LOS显著相关。住院患者数量与较短的LOS显著相关。在亚组分析中，这些因素中的大多数是一致的，虽然有些是不相关的延长LOS.Conclusion：不仅临床因素，而且机构的特点与延长LOS。本研究为改善精神科服务提供了有用的信息，并指出需要考虑医疗/福利机构之间的角色分工和精神科相关资源分配。应考虑采取干预措施，以缩短精神病患者的LOS。
Aim: Hospital length of stay (LOS) is one of the stratified measures of health-care efficiency and is commonly used to assess performance of psychiatric care. The aim of this study was to identify risk factors for prolonged LOS of psychiatric patients.Methods: We retrospectively analyzed adult psychiatric patients (ICD-10; F00-F99) between April 2012 and March 2014 in the Japanese Diagnosis Procedure Combination database. We examined factors affecting prolonged LOS using multivariable logistic regression analysis. Subgroup analyses of the logistic regression were undertaken according to two diagnostic groups (F20-F29 and F30-F39).Results: A total of 34 326 patients admitted to and discharged from psychiatric beds were included. Older age, lower Global Assessment of Functioning score, involuntary commitment, several psychiatric services, certain other patient factors, academic hospitals, public hospitals, and higher density of psychiatric beds were significantly associated with prolonged LOS. Hospital patient volume was significantly associated with shorter LOS. In the subgroup analyses, most of these factors were consistent although some were not associated with prolonged LOS.Conclusion: Not only clinical factors but also institutional characteristics were associated with prolonged LOS. Our study provided useful information for improvement in psychiatric services and indicated the need to consider the division of roles between healthcare/welfare institutions and psychiatricrelated resource allocation. Interventions should be considered for achieving shorter LOS for psychiatric patients.