J Prev Med Public Health.  2009 Nov;42(6):416-423. 10.3961/jpmph.2009.42.6.416.

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

Affiliations
  • 1Department of Health Policy and Management, Seoul National University College of Medicine, Seoul, Korea. phealth@snu.ac.kr
  • 2Institute of Health Policy and Management, SNUMRC, Seoul, Korea.
  • 3Department of Neuropsychiatry, Kangwon National University School of Medicine, Chuncheon, Korea.
  • 4Seoul Mental Health Center, Seoul, Korea.
  • 5Department of Psychiatry, Incheon Medical Center, Incheon, Korea.

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.

Keyword

Psychiatric diagnosis; Inpatients; Length of stay

MeSH Terms

Adult
Alcoholism/*therapy
Confidence Intervals
Female
Hospitalization/*statistics & numerical data
Humans
Length of Stay/*statistics & numerical data
Male
Mental Disorders
Mental Health Services/*utilization
Middle Aged
Mood Disorders/*therapy
Multivariate Analysis
Odds Ratio
Psychometrics
Psychotic Disorders/*therapy
Republic of Korea
Schizophrenia/*therapy
Time Factors
Young Adult
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