Psychiatric readmissions and their association with environmental and health system characteristics: a systematic review of the literature.
Psychiatric readmissions and their association with environmental and health system characteristics: a systematic review of the literature.
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DOI：
10.1186/s12888-016-1099-8
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发表时间：
2016-11-07
期刊：
影响因子：
4.4
通讯作者：
Magnussen J
中科院分区：
文献类型：
--
作者：
Kalseth J;Lassemo E;Wahlbeck K;Haaramo P;Magnussen J
精神科的再入院治疗已经被详细研究过了。然而，关于环境和卫生系统特征如何影响再入院率的知识很少。本文系统地回顾和讨论了健康和社会系统以及环境特征对精神疾病诊断患者出院后再入院的影响。在Ovid Medline、emocINFO、ProQuest Health Management和OpenGrey电子书目数据库中进行了全面的文献搜索。此外，谷歌学者也得到了利用。收录了1990年1月至2014年6月期间出版的相关出版物。没有对语言或出版状态施加任何限制。对纳入的研究进行了定性综合。描述系统和环境特征的变量被分为三类：反映监管、融资体系和治理的变量；反映能力、组织和结构的变量；以及反映环境变量的变量。在最初的搜索中确定的734篇独特的文章中，有35篇纳入了这项研究。关于精神科再入院及其与环境和卫生系统特征的关系的研究数量有限。尽管综述揭示了所研究的大量特征，但大多数特征出现在数量非常有限的文章中。最常被研究的特征是与位置有关的(当地、地区/地区/国家)。在大多数情况下，发现了地区差异，这有力地表明，再入院的风险不仅与患者的特征有关，还与不同地区之间的系统和/或环境因素有关。文献还指出，精神科患者的住院时间和社区善后护理与再入院之间存在负相关。这篇综述表明，对系统级变量的分析很少。此外，它们在目的、系统特征的选择以及衡量这些特征的方式方面也不同。缺乏研究重新接纳和服务提供者付费模式之间关系的研究令人震惊。如果没有与提供者支付模式以及与监管、筹资系统和治理结构有关的其他卫生系统特征的联系，就更难从这些分析中得出政策影响。本文的在线版本(doi：10.1186/s12888-0161099-8)包含补充材料，授权用户可以使用。
Psychiatric readmissions have been studied at length. However, knowledge about how environmental and health system characteristics affect readmission rates is scarce. This paper systemically reviews and discusses the impact of health and social systems as well as environmental characteristics for readmission after discharge from inpatient care for patients with a psychiatric diagnosis. Comprehensive literature searches were conducted in the electronic bibliographic databases Ovid Medline, PsycINFO, ProQuest Health Management and OpenGrey. In addition, Google Scholar was utilised. Relevant publications published between January 1990 and June 2014 were included. No restrictions regarding language or publication status were imposed. A qualitative synthesis of the included studies was performed. Variables describing system and environmental characteristics were grouped into three groups: those capturing regulation, financing system and governance; those capturing capacity, organisation and structure; and those capturing environmental variables. Of the 734 unique articles identified in the original search, 35 were included in the study. There is a limited number of studies on psychiatric readmissions and their association with environmental and health system characteristics. Even though the review reveals an extensive list of characteristics studied, most characteristics appear in a very limited number of articles. The most frequently studied characteristics are related to location (local area, district/region/country). In most cases area differences were found, providing strong indication that the risk of readmission not only relates to patient characteristics but also to system and/or environmental factors that vary between areas. The literature also points in the direction of a negative association of institutional length of stay and community aftercare with readmission for psychiatric patients. This review shows that analyses of system level variables are scarce. Furthermore they differ with respect to purpose, choice of system characteristics and the way these characteristics are measured. The lack of studies looking at the relationship between readmissions and provider payment models is striking. Without the link to provider payment models and other health system characteristics related to regulation, financing system and governance structure it becomes more difficult to draw policy implications from these analyses. The online version of this article (doi:10.1186/s12888-016-1099-8) contains supplementary material, which is available to authorized users.
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影响因子：
6.6
作者：
EATON, WW;MORTENSEN, PB;WOOFF, K
通讯作者：
WOOFF, K
影响因子：
4.4
作者：
Hodgson, RE;Lewis, M;Boardman, AP
通讯作者：
Boardman, AP
DOI：
10.1007/bf02518628
发表时间：
1995-09-01
期刊：
JOURNAL OF MENTAL HEALTH ADMINISTRATION
影响因子：
--
作者：
MOOS, RH;MERTENS, JR;BRENNAN, PL
通讯作者：
BRENNAN, PL
DOI：
10.1590/s1807-59322010000500005
发表时间：
2010-05
期刊：
Clinics (Sao Paulo, Brazil)
影响因子：
--
作者：
Lin CH;Chen WL;Lin CM;Lee MD;Ko MC;Li CY
通讯作者：
Li CY
DOI：
10.1007/s11414-013-9323-5
发表时间：
2013-04-01
影响因子：
1.9
作者：
Mark, Tami;Tomic, Karen Smoyer;Smith, Shelagh
通讯作者：
Smith, Shelagh