Inpatient psychiatric bed capacity within CMS-certified U.S hospitals, 2011-2023: A cross-sectional study.

IF 15.8 1区 医学 Q1 Medicine
Zoe Lindenfeld, Jonathan H Cantor, Colleen M McCullough, Jemar R Bather, Ryan K McBain
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引用次数: 0

Abstract

Background: Despite persistently high rates of mental illness and suicide, receipt of treatment for mental health conditions remains low. In this context, it is important to quantify the number of inpatient psychiatric beds (IPBs), and to understand differences in the number of IPBs throughout the U.S, as these provide critical evaluation, medication, and stabilization services.

Methods and findings: This study used nationally-representative data drawn from the 2011-2023 Centers for Medicare and Medicaid Services' Healthcare Cost Report Information System (HCRIS). From 2011-2023, while the total number of IPBs-in both psychiatric hospitals (PHs) and short-term acute care hospitals (STACHs)-did not change, the number IPBs within STACHs fell from 11.3 in 2011 to 9.06 in 2023. During this period, 846 counties (in which over 244 million individuals reside) experienced a decline in the rate of IPBs, while another 1,449 counties (in which 59 million individuals reside) never had IPBs. In regression models predicting the number of IPBs in STACHs and PHs, hospitals that received DSH payments (STACHs: IRR:1.93, 95% CI: 1.72, 2.15; PHs: IRR:1.40; 95% CI: 1.06, 1.84), had more full-time employees (STACHs: IRR:1.35, 95% CI: 1.31, 1.38; PHs: IRR:1.77; 95% CI: 1.75, 1.80) and were teaching STACHs (STACHs: IRR:1.78; 95% CI: 1.63, 1.95) had significantly more IPBs. In county-level regression models, counties with a lower percentage of Black residents (β: -21.15; 95% CI: -37.14, -5.16) had a significantly higher rate of IPBs. The absence of a causal design means we cannot assess the reasons behind changes in IPBs across time, and is a limitation of this study.

Conclusions: This study provides an overview of the availability of IPBs throughout the U.S, as well as the number of individuals without access to IPBs. Findings indicate a dearth of STACH-based IPBs, particularly in areas with a greater proportion of racial minority residents.

2011-2023年美国cms认证医院的住院精神病病床容量:一项横断面研究
背景:尽管精神疾病和自杀率一直很高,但接受精神健康状况治疗的人数仍然很低。在这种情况下,重要的是量化住院精神病病床(IPBs)的数量,并了解美国各地IPBs数量的差异,因为这些病床提供关键的评估、药物治疗和稳定服务。方法和发现:本研究使用了2011-2023年医疗保险和医疗补助服务中心医疗成本报告信息系统(HCRIS)中具有全国代表性的数据。从2011年到2023年,虽然精神病院和短期急症护理医院的ipb总数没有变化,但短期急症护理医院内的ipb数量从2011年的11.3个下降到2023年的9.06个。在此期间,846个县(超过2.44亿人居住)经历了IPBs率的下降,而另外1449个县(5900万人居住)从未发生IPBs。在预测STACHs和PHs中IPBs数量的回归模型中,接受DSH付款的医院(STACHs: IRR:1.93, 95% CI: 1.72, 2.15;小灵通:IRR: 1.40;95% CI: 1.06, 1.84),有更多的全职员工(STACHs: IRR:1.35, 95% CI: 1.31, 1.38;小灵通:IRR: 1.77;95% CI: 1.75, 1.80)和教授STACHs (STACHs: IRR:1.78;95% CI: 1.63, 1.95)的IPBs显著增加。在县级回归模型中,黑人居民比例较低的县(β: -21.15;95% CI: -37.14, -5.16) IPBs发生率显著升高。缺乏因果设计意味着我们无法评估IPBs随时间变化背后的原因,这是本研究的局限性。结论:本研究概述了美国IPBs的可用性,以及无法获得IPBs的个人数量。调查结果表明,以stach为基础的ipb缺乏,特别是在少数民族居民比例较大的地区。
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
PLoS Medicine
PLoS Medicine MEDICINE, GENERAL & INTERNAL-
CiteScore
17.60
自引率
0.60%
发文量
227
审稿时长
4-8 weeks
期刊介绍: PLOS Medicine is a prominent platform for discussing and researching global health challenges. The journal covers a wide range of topics, including biomedical, environmental, social, and political factors affecting health. It prioritizes articles that contribute to clinical practice, health policy, or a better understanding of pathophysiology, ultimately aiming to improve health outcomes across different settings. The journal is unwavering in its commitment to uphold the highest ethical standards in medical publishing. This includes actively managing and disclosing any conflicts of interest related to reporting, reviewing, and publishing. PLOS Medicine promotes transparency in the entire review and publication process. The journal also encourages data sharing and encourages the reuse of published work. Additionally, authors retain copyright for their work, and the publication is made accessible through Open Access with no restrictions on availability and dissemination. PLOS Medicine takes measures to avoid conflicts of interest associated with advertising drugs and medical devices or engaging in the exclusive sale of reprints.
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