Journal of Preventive Medicine and Public Health

The Korean Society for Preventive Medicine (대한예방의학회)
권호 표지
DOI QR코드

DOI QR Code

Medical Care Utilization Status and Associated Factors with Extended Hospitalization of Psychiatric Patients in Korea

우리나라 정신질환자의 의료이용 현황과 장기입원 관련 요인

  • Suh, Soo-Kyung (Department of Health Policy and Management, Seoul National University College of Medicine) ;
  • Kim, Yoon (Department of Health Policy and Management, Seoul National University College of Medicine) ;
  • Park, Jong-Ik (Department of Neuropsychiatry, Kangwon National University School of Medicine) ;
  • Lee, Myung-Soo (Seoul Mental Health Center) ;
  • Jang, Hong-Suk (Department of Psychiatry, Incheon Medical Center) ;
  • Lee, Sun-Young (Institute of Health Policy and Management, SNUMRC) ;
  • Lee, Jin-Seok (Department of Health Policy and Management, Seoul National University College of Medicine)
  • 서수경 (서울대학교 의과대학 의료관리학교실) ;
  • 김윤 (서울대학교 의과대학 의료관리학교실) ;
  • 박종익 (강원대학교 신경정신과학교실) ;
  • 이명수 (서울시 정신보건센터) ;
  • 장홍석 (인천광역시의료원 정신과) ;
  • 이선영 (서울대학교 의학연구원 의료관리학연구소) ;
  • 이진석 (서울대학교 의과대학 의료관리학교실)
  • Published : 2009.11.30
Download PDF
⟨ Previous Next ⟩

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.

Keywords

References

  1. Mattes JA, Rosen B, Klein DF. Comparison of the clinical effectiveness of “short”versus "ong"stay psychiatric hospitalization: II. Results of a 3-year posthospital follow-up. J Nerv Ment Dis 1977; 165(6): 387-394 https://doi.org/10.1097/00005053-197712000-00004
  2. McGorry PD, Killackey E, Yung AR. Early intervention in psychotic disorders: Detection and treatment of the first episode and the critical early stages. Med J Aust 2007; 187(7 suppl): S8-S10
  3. Thornicroft G, Bebbington P, Leff J. Outcomes for long-term patients one year after discharge from a psychiatric hospital. Psychiatr Serv 2005; 56(11): 1416-1422 https://doi.org/10.1176/appi.ps.56.11.1416
  4. Suh DW. Length of stay of psychiatric inpatients by sociodemographic and clinical characteristics, and type of facilities. J Korean Neuropsychiatr Assoc 2002; 41(6): 1174-1184. (Korean)
  5. The Central Mental Health Supporting Committee. National Mental Health 10-year Plan. Seoul: Ministry of Health and Welfare, Korean Institute for Health and Social Affairs; 2007. (Korean)
  6. Lee YM, Kim JH, Lee HY, Jeong YK, Lim KY, Lee JH, et al. Length of stay in the mental health facilities in Korea. J Korean Neuropsychiatr Assoc 1998; 37(1): 83-94. (Korean)
  7. Kim JO, Lee YS, Lee KH. A clinical study of "short” versus" long" psychiatric hospitalization in adolescents. J Korean Neuropsychiatr Assoc 1994; 33(4): 718-728. (Korean)
  8. Lee YM, Lee HY, Lim KY. Case mix of psychiatric inpatients in Korea. Ajou Med J 1996; 1(1): 193-199. (Korean)
  9. National Health Insurance Corporation. 2007 National Health Insurance Statistical Yearbook. Seoul: National Health Insurance Corporation; 1998. p. 428. (Korean)
  10. Kim KK. A public health approach to drinking patterns and alcohol-related problems. J Korean Public Health Assoc 1996; 22(1): 162- 192. (Korean)
  11. Munich RL, Gabbard GO. Hospital psychiatry. In: Tasman A, Riba MB, editors. Review of Psychiatry. Vol. 11. Washington DC: American Psychiatric Press; 1992. p. 501-534
  12. Lee JH, Ahn IN, Oh SW, Chung YC, Choi YM, Won JS, et al. A clinical study of the psychiatric in-patients during nine years. Inje Med J 1983; 4(2): 153-165. (Korean)
  13. Waraich P, Goldner EM, Somers JM, Hsu L. Prevalence and incidence studies of mood disorders: A systematic review of the literature. Can J Psychiatry 2004; 49(2): 124-138 https://doi.org/10.1177/070674370404900208
  14. Somers JM, Goldner EM, Waraich P, Hsu L. Prevalence studies of substance-related disorders: A systematic review of the literature. Can J Psychiatry 2004; 49(6): 373-384 https://doi.org/10.1177/070674370404900606
  15. Min SK. Modern Psychiatry. 5th ed. Seoul: Ilchokak; 2006. p. 243-245. (Korean)
  16. Snowdon J. How many bed-days for an area’s psychogeriatric patients? Aust N Z J Psychiatry 1993; 27(1): 42-48 https://doi.org/10.3109/00048679309072122
  17. Kolbasovsky A, Reich L, Futterman R. Predicting future hospital utilization for mental health conditions. J Behav Health Serv Res 2007; 34(1): 34-42 https://doi.org/10.1007/s11414-006-9044-0
  18. Kastrup M. Prediction and profile of the longstay population: A nation-wide cohort of first time admitted patients. Acta Psychiatr Scand 1987; 76(1): 71-79 https://doi.org/10.1111/j.1600-0447.1987.tb02864.x
  19. Thompson A, Shaw M, Harrison G, Ho D, Gunnell D, Verne J. Patterns of hospital admission for adult psychiatric illness in England: Analysis of hospital episode statistics data. Br J Psychiatry 2004; 185: 334-341 https://doi.org/10.1192/bjp.185.4.334
  20. Mattes JA, Rosen B, Klein DF. 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 1977; 165(6): 387-394 https://doi.org/10.1097/00005053-197712000-00004
  21. Aitchison KJ, Meehan K, Murray RM. First Episode Psychosis. London: Martin Dunitz; 1999. p. 1-8
  22. Jakubaschk J, Waldvogel D, Wurmle O. Differences between long-stay and short-stay inpatients and estimation of length of stay: A prospective study. Soc Psychiatry Psychiatr Epidemiol 1993; 28(2): 84-90 https://doi.org/10.1007/BF00802097
  23. Hendryx MS, DeRyan J. Psychiatric hospitalization characteristics associated with insurance type. Adm Policy Ment Health 1998; 25(4): 437-448 https://doi.org/10.1023/A:1022248725615
  24. Chapireau F. Old and new long stay patients in French psychiatric institutions: results from a national random survey with two-year followup. Encephale 2005; 31(4 Pt 1): 466-476 https://doi.org/10.1016/S0013-7006(05)82408-X
  25. Heiman EM, Shanfield SB. Length of stay for patients in one city's hospitals with psychiatric units. Hosp Community Psychiatry 1980; 31(9): 632-634
  26. Lelliott P, Wing J, Clifford P. A national audit of new long-stay psychiatric patients: I: Method and description of the cohort. Br J Psychiatry 1994; 165(2): 160-169 https://doi.org/10.1192/bjp.165.2.160

Cited by

  1. Psychosocial Correlates of Length of Stay of Institutionalized Patients with Mental Illness vol.52, pp.2, 2013, https://doi.org/10.4306/jknpa.2013.52.2.98
  2. A Study on Factors Related to Long-term Hospitalization in Patients with Chronic Schizophrenia vol.54, pp.1, 2015, https://doi.org/10.4306/jknpa.2015.54.1.76
  3. Efficacy of Case Management for the Community Dwelling Schizophrenia Patients : A 36-Month Prospective Follow-Up Study vol.54, pp.4, 2009, https://doi.org/10.4306/jknpa.2015.54.4.578
  4. Continuation of schizophrenia treatment with three long-acting injectable antipsychotics in South Korea: A nationwide population-based study vol.29, pp.9, 2009, https://doi.org/10.1016/j.euroneuro.2019.07.138
  5. Differences in Social and Clinical Characteristics between Readmission and Dehospitalization in Long-Term Inpatients with Schizophrenia vol.23, pp.1, 2009, https://doi.org/10.16946/kjsr.2020.23.1.38