Length of stay and recidivism in schizophrenia: a study of public psychiatric hospital patients.
Length of stay and recidivism in schizophrenia: a study of public psychiatric hospital patients.
复制标题
精神分裂症的住院时间和累犯：对公立精神病医院患者的研究。
DOI：
10.1176/ajp.150.1.72
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发表时间：
1993
期刊：
影响因子：
--
通讯作者：
Donald Hedeker
中科院分区：
文献类型：
--
作者：
Lawrence Appleby;Prakash N. Desai;Daniel J. Luchins;Robert D. Gibbons;Donald Hedeker
客观化
自1955年以来，公立医院的精神科床位减少了80%，但入院人数也相应增加，这主要是因为再次犯罪率很高。病床数目的减少部分是因为缩短了住院时间，而在1970至1980年间，住院时间减少了一半。这项研究是为了确定住院治疗时间是否影响精神分裂症患者的复发率和复发率。
方法
从10家州立医院收集了1500名患者的数据，时间为首次出院后18个月。预测变量包括年龄、性别、婚姻状况、种族、既往入院人数、设施位置和住院时间。采用COX回归模型对初次复发的两次：30天和18个月(结果)进行生存分析。
结果
在剔除了既往住院次数和年龄的影响后，住院时间与每次复发的时间显著相关。设施的位置不能预测，但通过检查最大设施的数据来测试医院内的影响；再次，住院时间显著预测复发。
结论
尽管影响的幅度很小，但这些发现的临床意义在于，与接受较长时间治疗的患者相比，短暂停留的患者在出院后30天内再次住院的可能性更大。短期住院似乎普遍适用于精神病患者，但可能有一小部分但重要的严重精神病患者可能更适合其他选择，应该探索。
OBJECTIVE
Psychiatric beds in public hospitals have decreased 80% since 1955, but admissions have risen correspondingly, largely because of high recidivism rates. Decreases in numbers of beds have been partly achieved by shortening the length of stay, which lessened by half between 1970 and 1980. This study was undertaken to determine whether duration of hospital treatment affects the rate and rapidity of relapse among schizophrenic patients.
METHOD
Data on 1,500 patients from 10 state hospitals were gathered for 18 months after initial discharge. Predictor variables included age, sex, marital status, race, number of previous admissions, location of the facility, and length of stay. Data were analyzed by survival analysis with a Cox regression model for two times to initial relapse: 30 days and 18 months (outcome).
RESULTS
Length of stay was significantly related to each time to relapse after the effects of number of previous admissions and age were partialed out. Facility location was not predictive, but intrahospital effects were tested by examining the data on the largest facility; again, length of stay significantly predicted relapse.
CONCLUSIONS
Although the magnitude of the effect was small, the clinical significance of the findings is the greater likelihood that brief-stay patients will be rehospitalized within 30 days after discharge than will patients treated for longer periods. Brief hospitalization seems generally applicable to psychiatric populations, but there may be a small but important group of seriously mentally ill patients for whom other alternatives are possibly more appropriate and should be explored.