우리나라 정신질환자의 의료이용 현황과 장기입원 관련 요인
Medical Care Utilization Status and Associated Factors with Extended Hospitalization of Psychiatric Patients in Korea
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초록
Objectives : This study was performed to examine medical care utilization of psychiatric patients and to explore patients’characteristics associated with extended hospitalization. Methods : Data were extracted from information of Korean Health Insurance Review and Assessment Service. All data associated with admission and outpatient clinic visit were analysed by patient characteristics. We selected first psychiatric admission patients who diagnosed mental and behavioral disorders due to use of alcohol (main disease code: F10), schizophrenia and related disorders (F20-29) and mood disorders (F30~33) from January to June 2005. We analysed status of admission, mean length of stay, regular access to outpatient clinic and rates of extended hospitalization during 3 years. Bivariate and multivariate analyses were conducted to identify factors associated with extended hospitalization. Results : The number of psychiatric patients during the first six month of 2005 was 30,678. The mean length of stay was longest for schizophrenia and related disorders but shortest for mood disorders. Patients who experienced an extended hospitalization were 18.8% of total subjects. An extended hospitalization was more common in schizophrenia and related disorders than other diagnostic groups. The factors associated with the extended hospitalization were age, sex, diagnostic group, type of insurance and medical care utilization groups. Conclusions : The study indicates the problem of an extended hospitalization for psychiatric patients in Korea. It is suggested that variations in rates of extended hospitalization among medical care utilization group may need an active early intervention system in psychiatric treatment service. Particular attention needs to be devoted to planning and funding for reducing extended hospitalization.
Abstract
Objectives : This study was performed to examine medical care utilization of psychiatric patients and to explore patients’characteristics associated with extended hospitalization. Methods : Data were extracted from information of Korean Health Insurance Review and Assessment Service. All data associated with admission and outpatient clinic visit were analysed by patient characteristics. We selected first psychiatric admission patients who diagnosed mental and behavioral disorders due to use of alcohol (main disease code: F10), schizophrenia and related disorders (F20-29) and mood disorders (F30~33) from January to June 2005. We analysed status of admission, mean length of stay, regular access to outpatient clinic and rates of extended hospitalization during 3 years. Bivariate and multivariate analyses were conducted to identify factors associated with extended hospitalization. Results : The number of psychiatric patients during the first six month of 2005 was 30,678. The mean length of stay was longest for schizophrenia and related disorders but shortest for mood disorders. Patients who experienced an extended hospitalization were 18.8% of total subjects. An extended hospitalization was more common in schizophrenia and related disorders than other diagnostic groups. The factors associated with the extended hospitalization were age, sex, diagnostic group, type of insurance and medical care utilization groups. Conclusions : The study indicates the problem of an extended hospitalization for psychiatric patients in Korea. It is suggested that variations in rates of extended hospitalization among medical care utilization group may need an active early intervention system in psychiatric treatment service. Particular attention needs to be devoted to planning and funding for reducing extended hospitalization.
참고문헌 (26)
- Mattes JA, "Comparison of the clinical effectiveness of “short”versus “long”stay psychiatric hospitalization: II. Results of a 3-year posthospital follow-up", J Nerv Ment Dis, 165(6), pp.387~394 (1977)
- McGorry PD, "Early intervention in psychotic disorders: Detection and treatment of the first episode and the critical early stages", Med J Aust, 187(7), pp.S8~S10 (2007)
- Thornicroft G, "Outcomes for long-term patients one year after discharge from a psychiatric hospital", Psychiatr Serv, 56(11), pp.1416~1422 (2005)
- 서동우, "사회인구학 및 임상적 특성과 입원시설 종류에 따른 정신보건시설 입원환자의 재원기간 분포", 신경정신의학, 41(6), pp.1174~1184 (2002), 대한신경정신의학회
- The Central Mental Health Supporting Committee, "National Mental Health 10-year Plan" (2007), Ministry of Health and Welfare, Korean Institute for Health and Social Affairs
- Lee YM, "Length of stay in the mental health facilities in Korea", J Korean Neuropsychiatr Assoc, 37(1), pp.83~94 (1998)
- Kim JO, "A clinical study of“short”versus“ long”psychiatric hospitalization in adolescents", J Korean Neuropsychiatr Assoc, 33(4), pp.718~728 (1994)
- Lee YM, "Case mix of psychiatric inpatients in Korea", Ajou Med J, 1(1), pp.193~199 (1996)
- National Health Insurance Corporation, "2007 National Health Insurance Statistical Yearbook", pp.428~ (1998)
- Kim KK, "A public health approach to drinking patterns and alcohol-related problems", J Korean Public Health Assoc, 22(1), pp.162~192 (1996)
- Munich RL, ""Hospital psychiatry," in: Tasman A, Riba MB, editors. Review of Psychiatry. Vol. 11", pp.501~534 (1992), American Psychiatric Press
- Lee JH, "A clinical study of the psychiatric in-patients during nine years", Inje Med J, 4(2), pp.153~165 (1983)
- Waraich P, "Prevalence and incidence studies of mood disorders: A systematic review of the literature", Can J Psychiatry, 49(2), pp.124~138 (2004)
- Somers JM, "Prevalence studies of substance-related disorders: A systematic review of the literature", Can J Psychiatry, 49(6), pp.373~384 (2004)
- Min SK, "Modern Psychiatry", pp.243~245 (2006), Ilchokak
- Snowdon J, "How many bed-days for an area’s psychogeriatric patients?", Aust N Z J Psychiatry, 27(1), pp.42~48 (1993)
- Kolbasovsky A, "Predicting future hospital utilization for mental health conditions", J Behav Health Serv Res, 34(1), pp.34~42 (2007)
- Kastrup M, "Prediction and profile of the longstay population: A nation-wide cohort of first time admitted patients", Acta Psychiatr Scand, 76(1), pp.71~79 (1987)
- Thompson A, "Patterns of hospital admission for adult psychiatric illness in England: Analysis of hospital episode statistics data", Br J Psychiatry, (185), pp.334~341 (2004)
- Mattes JA, "Comparison of the clinical effectiveness of “short”versus “long”stay psychiatric hospitalization: II. Results of a 3-year posthospital follow-up", J Nerv Ment Dis, 165(6), pp.387~394 (1977)
- Aitchison KJ, "First Episode Psychosis", pp.1~8 (1999), Martin Dunitz
- Jakubaschk J, "Differences between long-stay and short-stay inpatients and estimation of length of stay: A prospective study", Soc Psychiatry Psychiatr Epidemiol, 28(2), pp.84~90 (1993)
- Hendryx MS, "Psychiatric hospitalization characteristics associated with insurance type", Adm Policy Ment Health, 25(4), pp.437~448 (1998)
- Chapireau F, "Old and new long stay patients in French psychiatric institutions: results from a national random survey with two-year followup", Encephale, 31(4), pp.466~476 (2005)
- Heiman EM, "Length of stay for patients in one city’s hospitals with psychiatric units", Hosp Community Psychiatry, 31(9), pp.632~634 (1980)
- Lelliott P, "A national audit of new long-stay psychiatric patients: I:Method and description of the cohort", Br J Psychiatry, 165(2), pp.160~169 (1994)