精神专科医院长期与短期住院患者对照研究

Long- stay and Short- stay Psychiatricin Patients

目的评估精神专科医院长期住院与短期住院精神障碍患者的特征,探讨导致患者延迟出院的相关因素。方法病例对照研究。对在规定的标定日期内住院时间>120天的长期住院组(病例组)与住院时间≤120天的短期住院组(对照组)进行社会人口学与临床特征的比较。结果病例组患者占有的床位数为我院总床位使用数的7%。社会人口学特征两组对比在年龄(χ2=11.7,P<0.05)、婚姻(χ2=15.8,P<0.001)、居住地(χ2=33.5,P<0.001)、付费方式(χ2=32.3,P<0.001)、家庭人均月收入(χ2=18.6,P<0.001)、监护人情况(χ2=50.5,P<0.001)方面的差异均存在统计学意义。临床特征病例组在平均病程(t=6.2,P<0.001)、入院次数(χ2=64.3,P<0.001)、有无躯体疾病(χ2=21.5,P<0.001)及精神科诊断(χ2=11.6,P<0.05)与对照组比较存在统计学差异。多因素logistic回归分析结果显示,患者长期住院的主要影响因素依次为付费方式、居住地、年龄、婚姻、文化、躯体疾病、职业。结论造成三级精神专科医院患者延迟出院的原因既有疾病本身的原因,也有家庭社会因素以及医保政策的原因。

Objective To assess the characteristics of long -stay psychiatric inpatients and short -stay psychiatric inpatient and i-dentify risk factors of delaying patient discharge from hospital .Methods Inpatients in Anding Hospital who had been hospitalized for more than 120 days（long-stay inpatients）during a specific index period were assessed with self made assessment instruments and com -pared to patients admitted during the same index period ,but staying in hospital for less than 120 days（short-stay inpatients）.Assessed domains included demographic and clinical characteristics .Logistic regression analysis was used to identify specific variables predicting inpatient long-stay status.Results Long-stay inpatients occupied around 7%of all beds in our hospital .There were significant distri-bution-differences in age（χ2 =11.7,P〈0.05）,marital status（χ2 =15.8,P〈0.001）,residence（χ2 =33.5,P〈0.001）,payment（χ2=32.3,P〈0.001）,income（χ2 =18.6,P〈0.001）,guardian（χ2 =50.5,P〈0.001）,course of disease（t=6.2,P〈0.001）,Admis-sion times（χ2 =64.3,P〈0.001）,physical disease or not （χ2 =21.5,P〈0.001） and psychiatric diagnosis （χ2 =11.6,P〈0.05） be-tween long-stay and short-stay patients emerged in terms of demographic and clinical characteristics .Mode of payment ,place of resi-dence,age,marital status,occupational status,education,somatic disease were the most powerful predictors of long -stay.Conclusion The results of this study suggest that many causes are association with psychiatric inpatients long duration of hospital stay .