| Summary: | 碩士 === 臺灣大學 === 醫療機構管理研究所 === 98 === Objectives: The reduction in the psychiatric bed rate in many countries was initially based on a preference for deinstitutionalization and the number of psychiatric beds increased at the same time in Taiwan. The reasonable utilization of psychiatric beds is undefined. The National Health Insurance (NHI) database was used to explore the utilization of psychiatric beds under different categories of overstay in Taiwan.
Methods: In this cross-sectional study, the discharged psychiatric inpatients in 2006 were collected from the NHI databases. The length of stay of patients with readmission within 1, 2 or 30 days was accumulated into the previous admission. The categories of overstay were divided into : 1) over 30, 60 or 90 acute hospital days, 2) over 60, 90, 150 or 180 chronic hospital days, 3) Length of stay over 75 or 90 percentile of inpatients, after adjusted the patients’ sex, age, DRG and co-morbidity by regression, and 4) over American average length of stay (LOS) of each psychiatric Medicare Severity Diagnosis Related Groups (MS-DRG), to estimate the total length of overstay in Taiwan.
Results: Under the same category of DRG as America and the length of stay of patients with readmission within 30 days was accumulated into the previous admission, overstay of acute inpatients and chronic inpatients were 1,634,732 and 2,258,471 person-days per year, respectively. Using risk adjusted length of stay over 90 percentile of acute inpatients were 216,407 person-days per year and the length of stay of patients with readmission within 30 days was accumulated into the previous admission, chronic inpatients were 136,335 person-days per year. After dividing by 365 days to produce the conserved beds, 593 - 4,479 acute beds and 374 - 6,188 chronic beds can be conserved, respectively.
Conclusions: The number of psychiatric beds per 10,000 population in Taiwan is more than some OECD countries, and the psychiatric inpatients has significant higher overstay in Taiwan. It is important to concern the psychiatric beds and resource allocation.
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