精神分裂症患者住院时间的影响因素分析  

Analysis of influencing factors of length of hospitalization in patients with schizophrenia

作　　者：侯明如 王军[1] 李现文[2] Hou Mingru;Wang Jun;Li Xianwen(General Psychiatry Department,Wuxi Mental Health Center,Wuxi 214151,China;School of Nursing,Nanjing Medical University,Nanjing 211166,China)

机构地区：[1]无锡市精神卫生中心普通精神科,214151 [2]南京医科大学护理学院,211166

出　　处：《神经疾病与精神卫生》2020年第12期855-860,共6页Journal of Neuroscience and Mental Health

基　　金：南京医科大学科技发展基金项目(2017NJMU179)。

摘　　要：目的 分析精神分裂症患者住院时间的影响因素.方法 采用整群抽样方法,回顾2018年1月1日至12月31日在无锡市精神卫生中心住院精神分裂症患者的电子病历系统,收集基本资料和临床资料,包括性别、年龄、工作、户口、监护人、住院付费方式、诊断分型、共病情况、住院次数、病程及住院时间.采用无序多分类Logistic回归分析不同住院时间的影响因素.结果 共调查1063例患者,平均年龄(49.97±15.58)岁,以男性(566例,53.25%)、失业(943例,88.71%)、城镇户口(916例,86.17%)、病程>5年(809例,76.11%)、住院>3次者(594例,55.87%)、偏执型分裂症(619例,58.23%)、共病躯体疾病(590例,55.5%)居多,以医保支付住院治疗费用者895例(84.2%).其中住院时间≤1个月占20.79%(221例);>1~3个月占34.34%(365例);>3~<12个月占11.00%(117例);≥12个月占33.87%(360例).回归分析显示,男性(OR=1.913,95%CI:1.326~2.759;OR=2.835,95%CI:1.717~4.679;OR=4.341,95%CI:2.782~6.772)、失业(OR=1.735,95%CI:1.082~2.780;OR=5.988,95%CI:2.376~15.087;OR=3.960,95%CI:1.901~8.248)、医保付费(OR=2.747,95%CI:1.820~4.145;OR=7.565,95%CI:3.502~16.342;OR=14.531,95%CI:6.430~32.839)是住院时间>1~3个月、>3~<12个月和≥12个月的共性影响因素;无核心照料者(OR=2.087,95%CI:1.178~3.696;OR=4.173,95%CI:2.539~6.856)、住院次数>3次(OR=1.775,95%CI:1.095~2.878;OR=4.272,95%CI:2.748~6.641)是住院时间>3个月的危险因素;年龄≥50岁(OR=2.290,95%CI:1.407~3.729)、病程>5年(OR=5.555,95%CI:2.749~11.228)、共病躯体疾病(OR=2.034,95%CI:1.301~3.181)是住院时间≥12个月的危险因素.结论 精神分裂症患者住院时间普遍较长,男性、失业、医保付费、无核心照料者、住院次数>3次、病程>5年、年龄≥50岁和共病躯体疾病与住院时间延长及长期住院密切相关.Objective To analyze the influencing factors of different length of hospitalization in patients with schizophrenia.Methods Cluster sampling was used to review the electronic medical record system for schizophrenia inpatients admitted to Wuxi Mental Health Center from January 1 to December 31 in 2018.Basic and clinical data were collected,including gender,age,job,household registration,guardian,payment method for hospitalization,diagnostic classification,comorbidities,length of hospitalization.Disordered multinomial logistic regression was used to analyze the influencing factors of the different length of hospitalization.Results A total of 1063 inpatients were investigated,with average age(49.97±15.58)years,male(566,53.25%),unemployment(943,88.71%),urban registered permanent residence(916,86.17%),course of disease more than 5 years(809,76.11%),number of hospitalizations more than 3 times(594,55.87%),paranoid schizophrenia(619,58.23%),comorbid somatic disease(590,55.5%),and medical insurance payment(895,84.2%).20.79%of the subjects were hospitalized for less than 1 month(221 cases);more than 1 month and less than 3 months accounted for 34.34%(365 cases);more than 3 months and less than 12 months accounted for 11.00%(117 cases);at least 12 months accounted for 33.87%(360 cases).Regression analysis showed that male(OR=1.913,95%CI:1.326-2.759;OR=2.835,95%CI:1.717-4.679;OR=4.341,95%CI:2.782-6.772),unemployment(OR=1.735,95%CI:1.082-2.780;OR=5.988,95%CI:2.376-15.087;OR=3.960,95%CI:1.901-8.248),medical insurance payment(OR=2.747,95%CI:1.820-4.145;OR=7.565,95%CI:3.502-16.342;OR=14.531,95%CI:6.430-32.839)were the common influencing factors of hospitalization length more than 1 and less than 3 months,more than 3 months and less than 12 months,and at least 12 months.Non-core caregivers(OR=2.087,95%CI:1.178-3.696;OR=4.173,95%CI:2.539-6.856),and more than 3 times of hospitalization(OR=1.775,95%CI:1.095-2.878;OR=4.272,95%CI:2.748-6.641)were important risk factors for hospitalization length more than 3 months.Age more than 50 ye

关 键 词：精神分裂症 住院时间 影响因素 

分 类 号：R749.3[医药卫生—神经病学与精神病学]