Past Issues

Objectives: Patients with psychiatric diseases are more likely to have medical
co-morbidities and increased mortality than those in the general population. Staff
at psychiatric institutions face challenges in the aspect of medical care toward
physical illnesses with limited medical resources, especially in the psychiatric
chronic ward. In this study, we intended to examine the characteristics and related
risk factors of transfers due to physical illnesses among individuals in the chronic
psychiatric ward. Methods: This is a retrospective chart review study. We extracted records of transfers due to physical illness among the patients in the chronic
psychiatric ward of Taoyuan Psychiatric Center from January 1, 2011 to June 30,
2013. Demographic data were also collected. Results: During the study period,
34.8% of the patients in the chronic psychiatric ward were ever transferred due to
physical illnesses. Of 455 episodes of transfers, 22.7% of them visited emergency
department at least once and 7.8% of them suffered from at least one general medical hospital admission. The most common diagnosis of transfers and further general medical hospital admission was pneumonia. Elder age (adjusted odds ratio =
1.04, 95% confidence interval = 1.02 - 1.06, p < 0.001) and schizophrenia diagnosis (AOR = 3.63, 95% CI = 1.51 - 8.68, p < 0.01) were significantly associated with
higher emergency department transfers. Further, elder age (AOR = 1.03, 95% CI=
1.01 - 1.06, p < 0.05) and smoking history (AOR = 2.71, 95% CI = 1.23 - 5.97, p
< 0.01) were also significantly associated with higher risk of pneumonia. Conclusion: High prevalence of medical transferals due to physical illness was found
among the chronic psychiatric ward. Studies further focusing on the physical
health among the chronic ward was mandated. Programs for enhancing psychical
health, early prevention and detection of physical diseases among individuals in
the chronic psychiatric ward are needed.