李欣洁,何红波,张杰.精神障碍住院患者出院后1年内再住院的危险因素[J].四川精神卫生杂志,2021,(1):69-74.
精神障碍住院患者出院后1年内再住院的危险因素
Risk factors of rehospitalization in psychiatric inpatients within one year after discharge
投稿时间:2020-09-24  
DOI:10.11886/scjsws20200924001
中文关键词:  中国  精神障碍患者  再住院率  住院天数
英文关键词:China  Patients with mental disorders  Rehospitalization rate  Length of stay
基金项目:
作者单位邮编
李欣洁 广州医科大学广东 广州 510000
佛山市第三人民医院广东 佛山 528000 
528000
何红波 广州医科大学附属脑科医院广东 广州 510000 510000
张杰 广州医科大学附属脑科医院广东 广州 510000 510000
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中文摘要:
      目的 探讨精神科住院患者出院后1年内再住院的危险因素,为临床评估及干预提供参考。方法 通过电子病历系统,收集2013年-2017年在广州医科大学附属脑科医院住院患者的信息。对患者再入院的危险因素进行生存分析,使用COX风险回归并绘制生存曲线,使用多元线性回归对患者出院后1年内至再次入院的间隔天数的影响因素进行分析。结果 22 807名住院患者中,有4 602名(20.2%)患者出院后1年内再入院。年龄、付款方式、疾病诊断、住院次数、住院天数均是再入院的危险因素(P均<0.01),其中,与年龄≤20岁的患者相比,21~30岁、31~40岁、41~50岁、51~60岁的患者再入院几率分别是其0.706、0.631、0.610、0.693倍;与住院次数1次的患者相比,入院2次、入院3次、入院4次的患者再入院几率分别是其3.015、2.824、4.271倍;与住院天数≤20天的患者相比,住院21~40天、≥101天的患者再入院几率分别是其1.142、1.181倍。年龄、住院天数、住院次数是出院后1年内何时发生再入院的影响因素:年龄越大,出院后距离下次再入院的间隔时间越长(B=0.017,P<0.01);与住院≤20天的患者相比,住院61~80天的患者更晚发生再入院(B=1.226,P<0.01);与住院次数为1次的患者相比,住院2次的患者更早发生再入院(B=-1.386,P<0.01)。结论 年龄≤20岁的患者、住院2次或4次及以上的患者在出院后1年内再入院几率较高;住院2次的患者出院后可能更早发生再入院;住院61~80天的患者可能更晚发生再入院。
英文摘要:
      Objective To explore the risk factors of rehospitalization of psychiatric inpatients within one year after discharge, so as to provide references for clinical evaluation and intervention.Methods Data of patients hospitalized in the Brain Hospital Affiliated to Guangzhou Medical University from 2013 to 2017 was collected through the electronic medical record system. Survival analysis was carried out to screen the risk factors for patient readmission. Cox risk regression and survival curve analysis were also performed, meantime, multiple linear regression was used to analyze the influencing factors of the time intervals between hospital discharge and subsequent readmission within one year.Results Among the 22 807 hospitalized patients, 4 602 cases (20.2%) were readmitted within one year after discharge. Age, payment methods, disease diagnosis, number of hospitalizations and hospitalization days were risk factors for readmission (P<0.01). The readmission rates of patients aged 21~30, 31~40, 41~50 and 51~60 were 0.706, 0.631, 0.610 and 0.693 times higher than those aged ≤20, respectively. The probability of readmission of patients with twice, three times and four times of hospitalization before was 3.015, 2.824 and 4.271 times higher than those with one time of hospitalization, respectively. The readmission rate of patients hospitalized for 21~40 days and above 101 days were 1.142 and 1.181 times higher than those hospitalized for less than 20 days, respectively. Age, hospitalization days and number of hospitalizations were the influencing factors of readmission within one year after discharge, and patients with older age had longer intervals between discharge and subsequent readmission (B=0.017, P<0.01). The time intervals between discharge and subsequent readmission were significantly longer among patients who had been hospitalized for 61~80 days than among patients who had been hospitalized for less than 20 days (B=1.226, P<0.01). Compared with patients with one time of hospitalization, the time intervals was significantly shorter among patients with twice of hospitalization (B=-1.386, P<0.01).Conclusion Patients aged below 20 years old and those with two, four or more times of hospitalization before have a high rate of readmission within one year after discharge, and the readmission time may be earlier among patients with two times of hospitalization, and relatively later among patients who had been hospitalized for 61~80 days.
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