Past Issues
Factors Associated with High-frequency Users of Psychiatric Services
in a Public Psychiatric Hospital in Taiwan
Kai-Jen Cheng, Kuo-Tung Chiang, Yue-Cune Chang, Kuo-Jung Chang, Pei-Shen Ho
Objective: The purpose of this study was to explore factors associated with
high-frequency users (HFUs) of psychiatric inpatient services in Taiwan compared
with low-frequency users (LFUs), focusing on their social, demographic, clinical
and service-related profi les. Methods: A random sample of 10% (n = 109) of all
subjects admitted to Beitou Armed Forces Hospital, in Taipei, Taiwan, from January
2008 to December 2010 were divided into HFUs (n = 38) and LFUs (n = 71)
in accordance with modifi ed Weiden’s criteria. We collected data from medical
records of HFUs and LFUs to assess the impact of the profi les on the patterns of
hospitalization. Results: According to these criteria, 34.9% of the study population
were HFUs. Logistic regression analyses indicated that community-based outpatient
services were signifi cantly associated with decreasingly more frequent readmissions
(p < 0.05). A Poisson regression model showed shorter mean length of
each admission (p < 0.001), a diagnosis of psychotic disorder due to general medical
condition (p < 0.001), suicidal behavior (p < 0.05) and educational level lower
than senior high school (p < 0.01) to be the signifi cant predictors of HFUs. Conclusions:
The most important factors related to frequency of hospitalization were
community-based outpatient services, shorter mean length of each admission, a
diagnosis of psychotic disorder due to general medical condition, suicidal behavior,
and educational level lower than senior high school. The mental health system
should therefore provide better resources to these patients to reduce hospitalization
rates.
high-frequency users (HFUs) of psychiatric inpatient services in Taiwan compared
with low-frequency users (LFUs), focusing on their social, demographic, clinical
and service-related profi les. Methods: A random sample of 10% (n = 109) of all
subjects admitted to Beitou Armed Forces Hospital, in Taipei, Taiwan, from January
2008 to December 2010 were divided into HFUs (n = 38) and LFUs (n = 71)
in accordance with modifi ed Weiden’s criteria. We collected data from medical
records of HFUs and LFUs to assess the impact of the profi les on the patterns of
hospitalization. Results: According to these criteria, 34.9% of the study population
were HFUs. Logistic regression analyses indicated that community-based outpatient
services were signifi cantly associated with decreasingly more frequent readmissions
(p < 0.05). A Poisson regression model showed shorter mean length of
each admission (p < 0.001), a diagnosis of psychotic disorder due to general medical
condition (p < 0.001), suicidal behavior (p < 0.05) and educational level lower
than senior high school (p < 0.01) to be the signifi cant predictors of HFUs. Conclusions:
The most important factors related to frequency of hospitalization were
community-based outpatient services, shorter mean length of each admission, a
diagnosis of psychotic disorder due to general medical condition, suicidal behavior,
and educational level lower than senior high school. The mental health system
should therefore provide better resources to these patients to reduce hospitalization
rates.
| Key Word | revolving door, psychiatric readmission, inpatient care |
|---|