绍兴市严重精神障碍患者健康体检的影响因素分析

Factors affecting physical examinations among patients with severe mental disorders in Shaoxing City

目的了解浙江省绍兴市严重精神障碍患者健康体检情况及其影响因素,为促进严重精神障碍患者每年健康体检提供依据。方法通过浙江省严重精神障碍管理信息系统收集2022年绍兴市纳入社区管理的严重精神障碍患者资料,包括人口学信息、疾病诊断、诊疗情况、健康体检和救助帮扶资料;采用多因素logistic回归模型分析健康体检的影响因素。结果2022年绍兴市严重精神障碍患者25468例,其中男性12151例,女性13317例,男女性别比为0.91∶1。年龄为(54.34±14.71)岁。疾病诊断以精神分裂症为主,15419例占60.54%。2022年完成健康体检21374例,占83.92%。多因素logistic回归分析结果显示,女性(OR=0.901,95%CI:0.832~0.975)、城镇(OR=0.506,95%CI:0.468~0.547)、癫痫所致精神障碍(OR=1.779,95%CI:1.104~2.866)、住院治疗次数(6~10次,OR=0.523,95%CI:0.401~0.681;≥11次,OR=0.177,95%CI:0.108~0.288)、办理门诊特殊病种(OR=1.738,95%CI:1.597~1.891)、接受医疗救助(OR=2.851,95%CI:2.616~3.107)、关爱帮扶小组服务对象(OR=1.653,95%CI:1.471~1.857)和监护人(配偶,OR=1.777,95%CI:1.513~2.086;子女,OR=1.277,95%CI:1.069~1.526;父母,OR=1.342,95%CI:1.143~1.576)与严重精神障碍患者健康体检存在统计学关联。结论绍兴市严重精神障碍患者2022年健康体检率为83.92%,性别、居住地、监护人、疾病诊断、住院治疗次数、医疗救助、门诊特殊病种和关爱帮扶小组服务对象影响严重精神障碍患者健康体检。

Objective To investigate the proportion of physical examinations among patients with severe mental disorders and its influencing factors in Shaoxing City,Zhejiang Province,so as to provide the evidence for improving the proportion of physical examinations among patients with severe mental disorders.Methods The epidemiological and clinical features of patients with severe mental disorders included in community management in Shaoxing City in 2022 were collected from Zhejiang Provincial Severe Mental Disorder Management Information System,including demographics,disease diagnosis and treatment,physical examination,and rescue and assistance.Factors affecting the physical examination were identified among patients with severe mental disorders using a multivariable logistic regression model.Results A total of 25468 patients with severe mental disorders were enrolled in Shaoxing City in 2022,including 12151 males and 13317 females,with a male to female ratio of 0.91∶1,and the participants had a mean age of(54.34±14.71)years.Schizophrenia was the predominant type of severe mental disorders(15419 cases,60.54%),and 21374 subjects participating in the physical examinations in 2022(83.92%).Multivariable logistic regression analysis showed that female(OR=0.901,95%CI:0.832-0.975),urban areas(OR=0.506,95%CI:0.468-0.547),mental disorders due to epilepsy(OR=1.779,95%CI:1.104-2.866),hospitalized treatment(6 to 10 times,OR=0.523,95%CI:0.401-0.681;11 times and more,OR=0.177,95%CI:0.108-0.288),special diseases in outpatient(OR=1.738,95%CI:1.597-1.891),receiving medical assistance(OR=2.851,95%CI:2.616-3.107),targets of the community care and assistance groups(OR=1.653,95%CI:1.471-1.857)and guardian(spouse,OR=1.777,95%CI:1.513-2.086;children,OR=1.277,95%CI:1.069-1.526;parents,OR=1.342,95%CI:1.143-1.576)were statistically associated with the proportion of physical examinations.Conclusions The proportion of health examinations was 83.92%among patients with severe mental disorders in Shaoxing City in 2022.Gender,residence,guardian,disease diagnosis,times of hospitalized treatment,medical assistance,special diseases in outpatients and target of community care and assistance groups were factors affecting health examinations among patients with severe mental disorders.