住院日控制對精神科住院病人之效益探討

The Value of Monitoring System of Length of Stay for Psychotic In-Patients -An Application of the SAS in Psychiatric Hospital

為減少病人不必要之延長住院，促使病人治療目標之早日達成，增加醫院有限病床之循環利用率，提昇病患醫療照顧品質，台北市立療養院依其治療哲學、政策、人力與歷年出院病人資料，為精神科住院病人訂定住院日標準常模（Norms for Length of Stay），並於民國七十四年起開始對急性病房之病人實施住院日的控制制度。在比較實施後444個與實施前415個精神病人之住院時間，發現兩樣本之住院時間有顯著的差異，實施後，病人的平均住院日顯然比實施前縮短。另在對未超期出院與超期出院病人的再住院作一年的追蹤研究，發現兩者的再住院率並無顯著不同，表示住院日審查控制制度對精神科病人住院時間確有其價值存在，若醫院能繼續加強此制度之推行，並增加家屬對病人的接受程度，則精神病人住院時間應可再被縮短。

In order to 1) increase the turnover rate of bed utility, 2) shorten the length of hospital stay, and 3) improve the quality of medical care, the Taipei City Psychiatric Center has established monitoring system of psychotic in patients in 1985. Comparison of the length of stay between the 415 patients discharged before the system was adopted and the 444 patients discharged on this system reveals that the average length of stay on the latter groups is significantly shorter than the former group of patients, A 1-year follow-up study on 2 groups of patient discharged within and ovar the length of norms shows no significant difference in readmissim rate. These findings clearly indicate the value of this system in treatmmt of psychotic patients. It is speculated that the length of stay of psychotic in-patients can be further shorten by continuous effort of this system and intensification of working with the key family members.