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題名：精神疾病社區復健使用者再入院及危險因素之探討
書刊名：臺灣公共衛生雜誌
作者：李亞璇／謝碧晴 引用關係／李中一／蘇慧芳 引用關係
作者(外文)：Li, Ya-hsuan／Hsieh, Pi-ching／Li, Chung-yi／Su, Hui-fang
出版日期：2013
卷期：32:6
頁次：頁586-598
主題關鍵詞：精神疾病；社區復健；再入院；Andersen醫療利用模式；Cox比例風險迴歸模式；Psychiatric disease；Community rehabilitation；Readmission；Andersen's behavioral model of health service utilization；Cox proportional hazard model
原始連結：連回原系統網址new window
相關次數：
  • 被引用次數被引用次數:期刊(4) 博士論文(0) 專書(0) 專書論文(0)
  • 排除自我引用排除自我引用:4
  • 共同引用共同引用:2
  • 點閱點閱:42
目標：參考Andersen第一與第二階段醫療服務利用行為模式，擬欲探討2000至2009年精神疾病社區復健使用者之個人特質，並且分析使用精神疾病社區復健病患歷經指標出院一年期間，其往後一年內再入院風險及相關危險因子。方法：採回溯性世代設計，資料出處為國衛院所發行之全民健康保險資料庫1999至2009年「居家照護特殊需求檔」，研究對象為2000至2007年精神疾病社區復健使用者為新收個案，共25,218人。以Cox比例風險迴歸模式預測精神疾病社區復健使用者在指標出院後經歷一年期間，其往後一年內再入院之風險。結果：研究發現以Cox迴歸模式在出院後一年內精神疾病社區復健使用次數為8－14次與≥15次的再入院風險較使用1－7次者低，女性、中區分局病患、精神分裂症患者與住院小於55天等變項，再入院之風險較低。結論：精神疾病社區復健使用次數越少之個案，其爾後再入院之風險比使用次數多者還高，值得健康照護相關人員進一步思考影響其使用的因素，另外，其使用的模式及其與再入院之關係為何？亦值得未來進一步探究。
Objectives: With reference to phase I and phase II of Andersen's behavioral model of health service utilization, the aims of this study were first to investigate the characteristics of community rehabilitation care users and then to analyze the frequency of readmission and its risk factors within one year after discharge from a hospital for the treatment of mental illness. Methods: A retrospective cohort study design was used. Data analyzed in this study were retrieved from the 'home care specific files' of the National Health Insurance Research Database issued by the National Institutes of Health between 1999 and 2009. A total of 25,218 people were new cases of community rehabilitation care between 2000 and 2007. In order to forecast these community rehabilitation care users' risk of readmission within one year after discharge, the Cox proportional hazard model was utilized. Results: We found that the adjusted hazard ratio was significantly lower for groups of 8-14 times users and 15 or more-times users of community rehabilitation care than for 1-7 times users (0.73 & 0.72 respectively) in the Cox regression model. Furthermore, the risk of readmission was lower for females, clients who were insured by sub-bureau in the middle of Taiwan, a diagnosis of schizophrenia, and a length of hospital stay less than 55 days. Conclusions: The lower the frequency of psychiatric patients' using community rehabilitation care, the higher the risk of readmission.
期刊論文
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3.Fennig, S.、Rabinowitz, J.、Fennig, S.(1999)。Involuntary first admissions of patients with schizophrenia as predictor of future admission。Psychiatr Serv，50，1049-1052。  new window
4.Gastal, F. L.、Andreoli, S. B.、Quintana, M. I.、Almeida, Gameiro M.、Leite, S. O.、McGrath, J.(2000)。Presicting the revolving door phenomenon among patients with schizophrenic, affective disorders and non-organic psychoses。Rev Saude Publica，34，280-285。  new window
5.Heeren, O.、Dixon, L.、Gavirneni, S.、Regenold, W. T.(2002)。The association between decreasing length of stay and readmission rate on a psychogeriatric unit。Psychiatr Serv，53，76-79。  new window
6.Bernardo, A. C.、Forchuk, C.(2001)。Factors associated with readmission to a psychiatric facility。Psychiatr Serv，52，1100-1102。  new window
7.Boden, R.、Brant, L.、Kieler, H.、Andersen, M.、Reutfors, J.(2011)。Early non-adherence to medication and other risk factors for rehospitalization in schizophrenia and schizoaffective disorder。Schizophr Res，113，36-41。  new window
8.Kopelowicz, A.、Lopez, S.、Zarate, R.(2006)。Expressed emotion and family interactions in Mexican Americans with schizophrenia。J Nerv Ment Dis，194，330-334。  new window
9.Suzuki, Y.、Yasumura, S.、Fukao, A.、Otani, K.(2003)。Associsted factors of rehospitalization among schizophrenic patients。Psychiatry Clin Neurosci，57，555-561。  new window
10.Figueroa, R.、Harman, J.、Engberg, J.(2004)。Use of claims data to examine the impact of length of inpatient psychiatric stay on readmission rate。Psychiatr Serv，55，561-565。  new window
11.Zilber, N.、Hornik-Lurie, T.、Lerner, Y.(2011)。Predictors of early psychiatric rehospitalization: a national case register study。Isr J Psychiatry Relat Sci，48，49-53。  new window
12.Bridge, J. A.、Barbe, R. P.(2004)。Reducing hospital readmission in depression and schizophrenia: current evidence。Current Opinion in Psychiatry，17(6)，505-511。  new window
13.Vasudeva, S.、Narendra, Kumar M. S.、Sekhar, K. C.(2009)。Duration of first admission and its relation to the readmission rate in a psychiatry hospital。Indian J Psychiatry，51，280-284。  new window
14.Burgess, P.、Bindman, J.、Leese, M.、Henderson, C.、Szmukler, G.(2006)。Do community treatment orders for mental illness reduce readmission to hospital?。Soc Psychiatry Psychiatr Epidemiol，41，574-579。  new window
15.Craig, T. K.、Garety, P.、Power, P.(2004)。The Lambeth Early Onset (LEO) Team: randomized controlled trial of the effectiveness of specialized care for early psychosis。BMJ，329，1067。  new window
16.吳希文、楊銘欽(20111000)。社區復健中心服務對精神分裂症病患後續醫療利用之影響。臺灣公共衛生雜誌，30(5)，422-435。new window  延伸查詢new window
17.Lin, C. H.、Chen, W. L.、Lin, C. M.、Lee, M. D.、Ko, M. C.、Li, C. Y.(2010)。Predictors of psychiatric readmissions in the shortand long-term: a population-based study in Taiwan。Clinics (Sao Paulo)，65，481-489。  new window
18.Bobier, C.、Warwick, M.(2005)。Factors associated with readmission to adolescent psychiatric care。Aust N Z J P sychiatry，39，600-606。  new window
19.Lin, H. C.、Tian, W. H.、Chen, C. S.、Liu, T. C.、Tsai, S. Y.、Lee, H. C.(2006)。The association between readmission rates and length of stay for schizophrenia: a 3-year population-based study。Schizophr Res，83，211-214。  new window
20.Lin, C. H.、Chen, M. C.、Chou, L. S.、Lin, C. H.、Chen, C. C.、Lane, H. Y.(2010)。Time to rehospitalization in patients with major depression vs. those with schizophrenia or bipolar I disorder in a public psychiatric hospital。Psychiatry Res，180，74-79。  new window
21.Lin, H. C.、Lee, H. C.(2009)。Psychiatrists’ caseload volume, length of stay and mental healthcare readmission rate: a three-yearpopulation-based study。Psychiatry Res，166，15-23。  new window
22.Ellis, A. R.、Konrad, T. R.、Thomas, K. C.、Morrissey, J. P.(2009)。County-level estimates of mental health professional supply in the United States。Psychiatr Serv，60，1315-1322。  new window
23.蔡艷清、嚴嘉楓、林金定(20040400)。精神疾病與智能障礙：流行病學與醫療照護需求分析。身心障礙研究，2(2)，95-108。  延伸查詢new window
24.Patel, N. C.、Dorson, P. G.、Edwards, N.、Mendelson, S.、Crismon, M. L.(2002)。One-year rehospitalization rates of patients discharged on atypical versus conventional antipsychotics。Psychiatr Serv，53，891-893。  new window
25.張作貞、宋麗玉、吳秀蘭(20101200)。影響臺灣精神疾病患者未持續或中斷就醫之風險因素探討 : 以精神分裂症及情感性精神病為例。醫護科技期刊，12(4)，265-279。new window  延伸查詢new window
26.賴美嬌、李佩育、薛淑滿(20060600)。精神病患重返社會接受度之探討。福爾摩莎醫務管理雜誌，2(1)，58-68。  延伸查詢new window
27.Csernansky, J. G.、Schuchart, E. K.(2002)。Relapse and rehospitalisation rates in patients with schizophrenia: effects of second generation antipsychotics。CNS Drugs，16，473-484。  new window
28.Rossi, A.、Amaddeo, F.、Bisoffi, G.、Ruqqeri, M.、Thornicroft, G.、Tansella, M.(2002)。Dropping out of care: inappropriate terminations of contact with community-based psychiatric services。Br J Psychiatry，181，331-338。  new window
29.Andersen, Ronald M.(1995)。Revisiting the behavioral model and access to medical care: Does it matter?。Journal of Health and Social Behavior，36(1)，1-10。  new window
30.Hodgson, R. E.、Lewis, M.、Boardman, A. P.(2001)。Prediction of Readmission to Acute Psychiatric Units。Social Psychiatry and Psychiatric Epidemiology，36(6)，304-309。  new window
學位論文
1.陳玟伶(2009)。台灣地區精神疾病住院病患之再住院率研究(碩士論文)。國立台北護理學院，台北。  延伸查詢new window
2.陳巧珊(2009)。社區復健模式對精神分裂症患者再入院風險影響(碩士論文)。臺北醫學大學。  延伸查詢new window
圖書
1.國家衛生研究院(2004)。台灣精神障礙者照護發展研討會彙編。苗栗：國家衛生研究院。  延伸查詢new window
2.葉英堃(1996)。承先啟後--對革新台北式精神醫療保健的私見。台北市立療養院年報。台北：台北市立聯合醫院。  延伸查詢new window
3.胡海國(1999)。精神分裂症--描述性精神病理。臺北：橘井文化事業股份有限公司。  延伸查詢new window
其他
1.World Health Organization(2001)。The world health report 2001--mental health: new understanding, new hope，http://www.who.int/whr/2001/en/index.html， 。  new window
2.衛生福利部。衛生統計系列（四）全民健康保險醫療統計，http://www.mohw.gov.tw/cht/DOS/Statistic_P.aspx?f_list_no=312&fod_list_no=2657&doc_no=13275， 2013/11/20。  new window
3.衛生福利部中央健康保險署。全民健康保險醫療費用支付標準，http://www.nhi.gov.tw/webdata/webdata.aspx?menu=20&menu_id=710&webdata_id=3633， 2013/08/26。  延伸查詢new window
4.衛生福利部中央健康保險署。服務據點，http://www.nhi.gov.tw/webdata/webdata.aspx?menu=17&menu_id=659&webdata_id=3515&WD_ID=669， 2013/04/28。  new window
5.行政院主計總處。統計標準分類，http://www.dgbas.gov.tw/public/Attachment/05191021271.xls， 2013/05/30。  延伸查詢new window
6.衛生福利部中央健康保險署。全民健康保險居家照護利用與精神病人社區復健辦理情形，http://www.mohw.gov.tw， 2012/03/17。  延伸查詢new window
7.衛生福利部中央健康保險署。特約醫事服務機構家數統計表，http://www.nhi.gov.tw/resource/Webdata/15050_1_10210特約醫事機構家數.xls， 2013/11/14。  延伸查詢new window
 
 
 
 
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