2016•臺灣精神醫學Requires access
Transfers due to Physical Illnesses among Patients in the Chronic Psychiatric Ward
Hui‐Chun Huang, Hung‐Yu Chan
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Abstract
Objectives: Patients with psychiatric diseases are more likely to have medical co-morbidities and increased mortality than those in the general population. Staff at psychiatric institutions face challenges in the aspect of medical care toward physical illnesses with limited medical resources, especially in the psychiatric chronic ward. In this study, we intended to examine the characteristics and related risk factors of transfers due to physical illnesses among individuals in the chronic psychiatric ward. Methods: This is a retrospective chart review study. We extracted records of transfers due to physical illness among the patients in the chronic psychiatric ward of Taoyuan Psychiatric Center from January 1, 2011 to June 30, 2013. Demographic data were also collected. Results: During the study period, 34.8% of the patients in the chronic psychiatric ward were ever transferred due to physical illnesses. Of 455 episodes of transfers, 22.7% of them visited emergency department at least once and 7.8% of them suffered from at least one general medical hospital admission. The most common diagnosis of transfers and further general medical hospital admission was pneumonia. Elder age (adjusted odds ratio = 1.04, 95% confi dence interval = 1.02 - 1.06, p ＜ 0.001) and schizophrenia diagnosis (AOR = 3.63, 95% CI = 1.51 - 8.68, p ＜ 0.01) were signifi cantly associated with higher emergency department transfers. Further, elder age (AOR = 1.03, 95% CI= 1.01 - 1.06, p ＜ 0.05) and smoking history (AOR = 2.71, 95% CI = 1.23 - 5.97, p ＜ 0.01) were also signifi cantly associated with higher risk of pneumonia. Conclusion: High prevalence of medical transferals due to physical illness was found among the chronic psychiatric ward. Studies further focusing on the physical health among the chronic ward was mandated. Programs for enhancing psychical health, early prevention and detection of physical diseases among individuals in the chronic psychiatric ward are needed.