| Summary: | 碩士 === 長庚大學 === 醫務管理學研究所 === 95 === The violence of psychiatric patients is a main perspective of health care issue and subsequent medical consumptions occurred following admission. To alleviate the aggressive conducts of psychiatric inpatients is the top priority of psychiatric medical staff team in a medical setting. Attacked by psychiatric inpatients is not a rare event for psychiatric staff’s regular practice. Such violence attacks by psychiatric inpatients can be avoided to some extent if we can develop a method to predict the occurrence of the adverse events. Among the efforts documented previously, there are many manifestations found to be associated with low cholesterol level, such as non-disease-related mortality, suicide, violent crime, abrupt aggression, and personality disorder. Thus, the objectives of this study are many folds. Firstly, explore factors associated with the occurrence of violence by analyzing medical charts and other anthropometrical data. Secondly, identify high risk groups of violence among acute psychiatric inpatients with their distinguished factors. Thirdly, analyze the subsequent medical consumptions of violent psychiatric inpatients and its determinants.
The study population includes all inpatients who were admitted to 4 acute wards at a mental hospital in northern Taiwan from Jan. 1st, 2005 to Dec. 31st, 2005. There are more than 1,400 admissions in this study setting annually. Data from nursing records, psychiatrist records, and medical consumptions were used for further analysis of this study. A questionnaire was administered during the study period. A matched case-control design with age and sex was conducted for the purpose of estimating difference derived from violence. There are 4 groups with 41 admissions in each category.
Medical consumables were found to be the most significant items related to the occurrence of violence. While adjusted with length of stay, the characteristics of high risk to violence among psychiatric inpatients were male, aged older than 37 years old, with diabetic mellitus, with hypertension, no substance abuse history, body mass index ＞25, cholesterol＜175 mg/dL、triglyceride＜97 mg/dL, and high education level. The violence among psychiatric inpatients has cost approximately NT 1,090,000 dollars annually to our limited health insurance resources. It is possible to use some indicators for pre-screening the violence of acute psychiatric inpatients, hence reducing medical consumptions in the future.
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