Assessment of psychiatric outcomes in Japan based on diagnostic procedure combination information.
We evaluated psychiatric care in terms of relationships between patient characteristics and a comprehensive measurement of psychiatric outcomes among inpatients with lengths of stay (LOSs) of 90 days or fewer in a psychiatric hospital in Japan. The sample consisted of inpatients discharged from an acute care psychiatric hospital between September 1 and December 31, 2007. Multivariate analyses were performed to identify patient characteristics related to the outcome of acute psychiatric care. The type of admission was related to difference in Global Assessment of Functioning (GAF) scores (P < 0.001), health care cost (P < 0.001), length of time spent in seclusion (P < 0.001), and length of time spent in restraints (P < 0.01). Diagnosis showed a minimal or non-existent relationship to the outcome variables. The GAF scores of involuntary patients with initially low scores on this axis were greatly improved at discharge. Patients who were admitted involuntarily received more coercive interventions and treatments, such as seclusion and restraints, than did patients with who were admitted voluntarily. Diagnostic groups did not differ in terms of GAF scores. Further studies utilizing diagnostic procedure combination (DPC) data from multiple medical institutions are necessary to verify the present findings.
Department of Health Services, Management and Policy, Kyushu University Graduate School of Medicine, Fukuoka, Japan. takeru-a@hsmp.med.kyushu-u.ac.jp
Takeru
T
Abe
Koji
K
Ikeda
Kenji
K
Kuroda
Akihito
A
Hagihara
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D003134:Commitment of Persons with Psychiatric Disorders / Q000706:statistics & numerical data; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006778:Hospitals, Psychiatric / Q000706:statistics & numerical data; D006801:Humans; D007564:Japan; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis*; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods* / Q000706:statistics & numerical data*; D010043:Outcome and Process Assessment, Health Care / Q000706:statistics & numerical data*