从急诊住院患者的调查看精神科专科医院的管理

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目的对经精神科急诊就诊后留院治疗(留院观察或抢救:半封闭急诊病房)及住院治疗(封闭式住院病房)的患者,就两种留在医院治疗的方式选择上,影响直接住院的因素进行调查分析,提供管理策略,为患者进行更好的服务。方法 2016年1月19日~5月10日在北京安定医院急诊就诊留院及住院患者共868例,使用自编调查表对影响直接住院的患者躯体因素、家属因素和其他因素3个方面进行调查。结果留院237例(27.3%),住院631例(72.7%);需要留在医院治疗的总体患者女性(54.95%)多于男性(45.05%),留院女性(63.29%)远多于男性(36.71%),住院女性(51.82%)多于男性(48.18%);首诊:留院100(32.79%),住院205(24.33%);伴有躯体疾病:留院86(36.29%):住院92(14.58%),糖尿病、高血压最常见,留院的程度重;影响患者不能直接住院的家属及其他因素中,家属要求陪护患者最常见,其次是病房没有床位。结论调整病房结构;加强全体精神科医生的高血压、糖尿病的诊疗培训,加强精神科急诊医生其余合并躯体疾病的培训;就家属能否住院陪护进行论证,找到适合的管理方法,解决影响直接住院的因素、提升患者满意度。 Objectives To evaluate the efficacy of direct inpatient treatment of patients who stay in hospital (observation or rescue in hospital or semi-closed emergency ward) and inpatient treatment (closed inpatient wards) after psychiatric emergency visits. The factors of investigation and analysis, to provide management strategies for patients with better service. Methods A total of 868 hospitalized and hospitalized patients were enrolled in the emergency department of Anding Hospital, Beijing from January 19 to May 10, 2016. Self-questionnaires were used to investigate the somatic factors, family members and other factors affecting the direct hospitalization survey. Results There were 237 (27.3%) hospitalized patients and 631 hospitalized patients (72.7%). There were more women (54.95%) than the male patients (45.05%), and the hospitalized women (63.29%) than the male patients (36.71%), hospitalized women (51.82%) were more than men (48.18%); first diagnosis: 100 (32.79%) were hospitalized and 205 (24.33%) were hospitalized; Hospitalization 92 (14.58%), diabetes, high blood pressure is most common, the degree of hospitalization is heavy; family members and other factors that affect the patient can not be directly hospitalized, family members require the most common accompanying patients, followed by wards without beds. Conclusions The ward structure should be adjusted. The training of all psychiatrists in the diagnosis and treatment of hypertension and diabetes mellitus should be stepped up. The rest of psychiatric emergency physicians should be trained in the management of physical illness. The family members should be hospitalized and escorted to find out the appropriate management methods to solve the problem of direct hospitalization Factors to enhance patient satisfaction.
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