一次和多次住院精神分裂症患者再住院分析

An analysis of rehospitalization rates of schizophrenic patients

目的 :比较 1次和≥ 2次住院精神分裂症患者出院后的再住院率 ,初步探讨影响再住院的相关因素。 方法 :1999年度出院的 833例住院精神分裂症患者纳入调查 ,使用自制的再住院及其相关因素调查表 ,于 2 0 0 3年 12月底前电话或入户调查出院后至少 4 8个月的情况。 结果 :6 6 4例完成调查 ,分为 1次住院组 (333例 )和多次住院组 (331例 )。用生存分析 (Kaplan Meier公式 )比较两组未再住院率 ,12个月末 (分别为 6 7 0 %和 6 1 6 % )、2 4个月末 (5 6 2 %和 4 8 9% )、36个月末 (4 6 0和 35 1% )和 4 8个月末 (4 1 1%和 2 8 7% )。Cox回归风险比例模型分析影响再住院的相关因素显示 ,与药物依从性、生活事件、自知力和家庭照顾相关 (P <0 0 5 ) ,药物依从性对再住院的贡献值 (1 719)最大。 结论 :1次住院精神分裂症患者出院后的再住院率较多次住院者低。

Objective:To compare the rehospitalization rates of schizophrenic patients with different hospitalization times,and to analysis the related factors. Method:By using home-made questionnaire about rehospitalization status and related factors,833 schizophrenic patients discharged during 1999 were surveyed for at least 48 months by telephone or visiting before the end of Dec.2003. Results:664 patients who accomplished the investigation were divided into two groups:first-time hospitalization group (n=333)and more than one-time hospitalization group(n=331). Non-rehospitalzation rates of two groups at the end of 12th,24th,36th,48th months were 67 0% and 61 6%,56 2% and 48 9%, 46 0 and 35 1% ,41 1% and 28 7% respectively by survival analysis (Kaplan-Meier formula). Using Cox regression proportional hazards model to analyze, it was found that the factors of drug compliance,life events,insight and family care contributed to rehospitalization (P<0 05),among which drug compliance had the biggest contribution value (1 719). Conclusion:The rehospitalization rates might be lower in patients with first-time admission than in patients with more than one-time admission,and drug compliance is the primary factor related to rehospitalization.