The relationship between community-based psychiatric rehabilitation pathways and re-hospitalization trajectories: A three-decade follow-up

IF 4.2 2区医学 Q1 PSYCHIATRY

Psychiatry Research Pub Date : 2024-09-23 DOI:10.1016/j.psychres.2024.116216

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引用次数: 0

Abstract

Psychiatric rehabilitation is essential for the recovery of individuals with schizophrenia. However, re-hospitalization is sometimes inevitable. This study examined the association between varied community psychiatric rehabilitation services (PRS) and long-term re-hospitalization parameters.

National registries provided data on 5163 adults diagnosed with schizophrenia and schizoaffective disorder. Patients with recurrent hospitalizations were tracked over three periods: before rehabilitation legislation (1991–2000), during rehabilitation implementation (2001–2009), and follow-up (2010–2017). Associations between PRS types and annual re-hospitalization days (ARHD) during follow-up were analyzed.

Findings revealed that the rehabilitation group had a median time-to-readmission of 757 days, while the non-rehabilitation group had 321 days. Combined residential and vocational rehabilitation was associated with a 20-day decrease in ARHD, while residential or vocational rehabilitation alone were associated with reductions of 2 and 5 days, respectively. Higher levels of residential support were linked to reduced ARHD. Of the vocational rehabilitation types, supported-employment and sheltered-workshops showed association with the greatest reductions in ARHD (17 days).

Overall, community-based PRS is linked to prolonged time-to-readmission and reduced re-hospitalization days. A combination of vocational and residential services is related to a synergistic decrease in re-hospitalization days. This suggests that recurrent hospitalization for patients who are using PRS is shorter and may be part of their recovery pathway.

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以社区为基础的精神病康复途径与再入院轨迹之间的关系：三十年的跟踪研究

精神康复对精神分裂症患者的康复至关重要。然而，再次住院有时是不可避免的。这项研究探讨了各种社区精神康复服务（PRS）与长期再住院参数之间的关系。国家登记处提供了 5163 名被诊断患有精神分裂症和情感分裂症的成年人的数据。在康复立法之前（1991-2000 年）、康复实施期间（2001-2009 年）和随访期间（2010-2017 年）这三个时期，对反复住院的患者进行了追踪调查。研究结果表明，康复组的再入院时间中位数为757天，而非康复组为321天。住院康复和职业康复相结合可使患者的恢复时间（ARHD）减少20天，而单独住院康复或职业康复则可分别减少2天和5天。居住支持水平越高，ARHD 天数越少。在职业康复类型中，辅助就业和庇护讲习班与急性呼吸道缺氧症的减少天数（17 天）关系最大。总体而言，基于社区的 PRS 与延长再入院时间和减少再入院天数有关。职业和住宿服务的结合与再住院天数的协同减少有关。这表明，使用 "患者康复计划 "的患者再次住院的时间更短，这可能是他们康复途径的一部分。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Psychiatry Research 医学-精神病学

CiteScore

17.40

自引率

1.80%

发文量

527

审稿时长

57 days

期刊介绍： Psychiatry Research offers swift publication of comprehensive research reports and reviews within the field of psychiatry. The scope of the journal encompasses: Biochemical, physiological, neuroanatomic, genetic, neurocognitive, and psychosocial determinants of psychiatric disorders. Diagnostic assessments of psychiatric disorders. Evaluations that pursue hypotheses about the cause or causes of psychiatric diseases. Evaluations of pharmacologic and non-pharmacologic psychiatric treatments. Basic neuroscience studies related to animal or neurochemical models for psychiatric disorders. Methodological advances, such as instrumentation, clinical scales, and assays directly applicable to psychiatric research.