| アブストラクト | OBJECTIVES: Evidence regarding the relationships between patient, hospital, and regional factors and early unplanned readmission (short-term outcome) in patients with bipolar disorder is lacking. This study aimed to examine risk factors associated with early unplanned readmission in patients with bipolar disorder. METHOD: We retrospectively analyzed adult bipolar patients (ICD-10; F31) between April 2012 and March 2014 in the Japanese Diagnosis Procedure Combination database. We examined factors affecting the 30-day unplanned readmission using multivariable logistic regression analysis. RESULTS: A total of 2688 patients admitted to psychiatric beds were included. Multivariate analysis showed that unchanged or exacerbation discharge outcome (adjusted odds ratio [aOR]: 1.93; 95% confidence interval [CI]: 1.06-3.51, p=0.031), unplanned or urgent admission settings (aOR: 1.51; 95% CI: 1.00-2.26, p=0.048), physical comorbidity (chronic pulmonary disease) (aOR: 4.74; 95% CI: 1.30-17.29, p=0.018), presence of psychiatric acute-care beds (aOR: 1.72; 95% CI: 1.02-2.87, p=0.040), and intermediate-level hospital psychiatric staffing (aOR: 1.82; 95% CI: 1.14-2.91, p=0.012) were significantly associated with higher early unplanned readmission, while higher density of psychiatrists in the area (aOR: 0.50; 95% CI: 0.29-0.87, p=0.014) was significantly associated with lower early unplanned readmission. CONCLUSIONS: The results suggest that not only careful management of high-risk patients but also consideration of functional differentiation in psychiatric inpatient care, psychiatric resource allocation, and follow-up support for patients with bipolar disorder are needed for reducing the early unplanned readmission rate. |
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| ジャーナル名 | General hospital psychiatry |
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| 投稿日 | 2019/3/27 |
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| 投稿者 | Shinjo, Daisuke; Tachimori, Hisateru; Maruyama-Sakurai, Keiko; Ohnuma, Tetsu; Fujimori, Kenji; Fushimi, Kiyohide |
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| 組織名 | Department of Information Technology and Management, The National Center of Child;Health and Development, Japan.;Department of Clinical Epidemiology, Translational Medical Center, National;Center of Neurology and Psychiatry, Japan; Institute for Global Health Policy;Research, National Center for Global Health and Medicine, Japan.;Department of Health Policy and Informatics, Tokyo Medical and Dental University,;Graduate School, Japan; Department of Epidemiology, Gillings School of Global;Public Health, University of North Carolina, Chapel Hill, United States of;America.;Department of Health Administration and Policy, Tohoku University, Japan.;Graduate School, Japan. Electronic address: kfushimi.hci@tmd.ac.jp. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/30913417/ |
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