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首页> 外文期刊>The Australian and New Zealand journal of psychiatry >Factors associated with length of stay and the risk of readmission in an acute psychiatric inpatient facility: a retrospective study.
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Factors associated with length of stay and the risk of readmission in an acute psychiatric inpatient facility: a retrospective study.

机译：与住院时间和急性精神病住院设施再次入院风险相关的因素：一项回顾性研究。

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OBJECTIVE: This study was to investigate factors influencing the length of stay and predictors for the risk of readmission at an acute psychiatric inpatient unit. METHOD: Two comparative studies were embedded in a retrospective cross-sectional clinical file audit. A randomly selected 226 episodes of admissions including 178 patients during a twelve-month period were reviewed. A total of 286 variables were collected and analysed. A case control study was employed in the study of length of stay. A retrospective cohort study was used to investigate the predictors for the risk of readmission. RESULTS: Logistic regression analyses showed that 10 variables were associated with length of stay. Seclusion during the index admission, accommodation problems and living in an area lacking community services predicted longer stay. During the follow-up period 82 patients (46%) were readmitted. Cox regression analyses showed 9 variables were related to the risk of readmission. Six of these variables increased the risk of readmission, including history of previous frequent admission, risk to others at the time of the index admission and alcohol intoxication. More active and assertive treatment in the community post-discharge decreased the risk of readmission. CONCLUSIONS: Length of stay is multifactorially determined. Behavioural manifestations of illness and lack of social support structures predicted prolonged length of stay. Good clinical practice did not necessarily translate to a shorter length of stay. Therefore, length of stay is predictable, but not readily modifiable within the clinical domain. Good clinical practice within the community following discharge likely reduces the risk of readmission. Quality of inpatient care does not influence the risk of readmission, which therefore raises a question about the validity of using the rate of readmission as an outcome measure of psychiatric inpatient care.
机译：目的：本研究旨在探讨影响住院时间的因素以及急性精神病住院患者再次入院风险的预测因素。方法：两项比较研究被纳入回顾性横断面临床档案审核中。回顾了在十二个月期间随机选择的226例入院病例，包括178例患者。总共收集并分析了286个变量。在住院时间的研究中采用了病例对照研究。一项回顾性队列研究用于调查再次入院风险的预测因素。结果：Logistic回归分析显示10个变量与住院时间相关。进入索引期间的隐居生活，住宿问题和缺乏社区服务的地区的生活预计将更长。在随访期间，重新入院的患者为82例（46％）。 Cox回归分析显示9个变量与再入院风险相关。这些变量中的六个增加了再次入院的风险，包括以前的频繁入院史，入院时对其他人的入院风险和酒精中毒。出院后在社区采取更积极和果断的治疗降低了再次入院的风险。结论：住院时间长短是多方面决定的。疾病的行为表现和缺乏社会支持结构预示了住院时间的延长。良好的临床实践未必会缩短住院时间。因此，住院时间是可预测的，但在临床范围内不容易修改。出院后社区内的良好临床实践可能会降低再次入院的风险。住院治疗的质量不会影响再次入院的风险，因此提出了一个问题，即使用再次入院率作为精神病住院治疗的结果指标的有效性。

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