■据报道,青年中儿童和青少年精神科的再入院率正在增加。
■该研究旨在确定在儿童和青少年精神科的青少年精神病患者的再入院率和与再入院相关的因素。
■豪登省一家专科医院,南非。
■这项回顾性队列研究利用了青少年住院病房五年内住院患者的记录数据。使用生存分析方法计算从指标入院起出院一年内的累积发生率和再入院发生率。通过应用多变量Cox比例风险回归模型确定与再入院显着相关的特征。
■在纳入分析的189名患者中,出院后1年内再入院的累积发生率为17.5%.发病率为每10000人天5.31次再入院。最终的多变量模型显示,精神分裂症的诊断(p=0.015),诊断为注意缺陷多动障碍(p=0.039),来自儿童和青年护理中心或临时安全护理(p=0.018)增加了再次入院的风险,而患有疾病(p=0.008)则降低了风险。
精神病诊断和住院护理可能是再次入院的潜在风险标志。改善保健和社会服务在住宿护理方面的合作将是有益的。
■确定使青少年精神病患者容易再次入院的因素可以告知并改善管理和风险评估。
UNASSIGNED: Readmission rates to child and adolescent psychiatric units among the youth have been reported to be increasing.
UNASSIGNED: The study aimed to determine the readmission rate and factors associated with readmission of adolescent psychiatric patients at a child and adolescent psychiatric unit.
UNASSIGNED: A specialised psychiatric hospital in Gauteng province, South Africa.
UNASSIGNED: This retrospective cohort study utilised data from the records of patients admitted to the adolescent inpatient unit over a period of five years. The cumulative incidence and incidence rate of readmission within one year of discharge from the index admission was calculated using survival analysis methods. Characteristics significantly associated with readmission were determined by applying the multivariable Cox proportional hazards regression model.
UNASSIGNED: Among the 189 patients included in the analysis, the cumulative incidence of readmission within one year of discharge was 17.5%. The incidence rate was 5.31 readmissions per 10 000 person-days. The final multivariable model showed that a diagnosis of schizophrenia (p = 0.015), a diagnosis of attention deficit hyperactivity disorder (p = 0.039), and coming from a child and youth care centre or temporary safe care (p = 0.018) increased the risk of readmission while having a medical condition (p = 0.008) reduced the risk.
UNASSIGNED: Psychiatric diagnosis and residential care could be potential risk markers for readmission. Improving the collaboration between health and social services in residential care would be beneficial.
UNASSIGNED: Identifying factors that predispose adolescent psychiatric patients to readmission can inform and improve management and risk assessments.