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Medical Care Utilization Status and Associated Factors with Extended Hospitalization of Psychiatric Patients in Korea

우리나라 정신질환자의 의료이용 현황과 장기입원 관련 요인

  • Suh, Soo-Kyung (Department of Health Policy and Management, Seoul National University College of Medicine) ;
  • Kim, Yoon (Department of Health Policy and Management, Seoul National University College of Medicine) ;
  • Park, Jong-Ik (Department of Neuropsychiatry, Kangwon National University School of Medicine) ;
  • Lee, Myung-Soo (Seoul Mental Health Center) ;
  • Jang, Hong-Suk (Department of Psychiatry, Incheon Medical Center) ;
  • Lee, Sun-Young (Institute of Health Policy and Management, SNUMRC) ;
  • Lee, Jin-Seok (Department of Health Policy and Management, Seoul National University College of Medicine)
  • 서수경 (서울대학교 의과대학 의료관리학교실) ;
  • 김윤 (서울대학교 의과대학 의료관리학교실) ;
  • 박종익 (강원대학교 신경정신과학교실) ;
  • 이명수 (서울시 정신보건센터) ;
  • 장홍석 (인천광역시의료원 정신과) ;
  • 이선영 (서울대학교 의학연구원 의료관리학연구소) ;
  • 이진석 (서울대학교 의과대학 의료관리학교실)
  • Published : 2009.11.30

Abstract

Objectives : This study was performed to examine medical care utilization of psychiatric patients and to explore patients' characteristics associated with extended hospitalization. Methods : Data were extracted from information of Korean Health Insurance Review and Assessment Service. All data associated with admission and outpatient clinic visit were analysed by patient characteristics. We selected first psychiatric admission patients who diagnosed mental and behavioral disorders due to use of alcohol (main disease code: F10), schizophrenia and related disorders (F20-29) and mood disorders (F30~33) from January to June 2005. We analysed status of admission, mean length of stay, regular access to outpatient clinic and rates of extended hospitalization during 3 years. Bivariate and multivariate analyses were conducted to identify factors associated with extended hospitalization. Results : The number of psychiatric patients during the first six month of 2005 was 30,678. The mean length of stay was longest for schizophrenia and related disorders but shortest for mood disorders. Patients who experienced an extended hospitalization were 18.8% of total subjects. An extended hospitalization was more common in schizophrenia and related disorders than other diagnostic groups. The factors associated with the extended hospitalization were age, sex, diagnostic group, type of insurance and medical care utilization groups. Conclusions : The study indicates the problem of an extended hospitalization for psychiatric patients in Korea. It is suggested that variations in rates of extended hospitalization among medical care utilization group may need an active early intervention system in psychiatric treatment service. Particular attention needs to be devoted to planning and funding for reducing extended hospitalization.

Keywords

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