| Summary: | 碩士 === 高雄醫學大學 === 醫學系神經學科碩士班 === 100 === Purpose: The amending mental health act changed the process of compulsory admission and had great impact on the clinical practice. This research use the National Health Insurance Research Database to explore the difference of factors related with compulsory admission before and after the amending mental health act.
Method: We analyzed the data in 2006 and 2009 to identify the factors before and after amending mental health act. The collected data including patient’s data ( age, gender , comorbidity ,insurance count, urbanization), hospital’s data (hospital levels, hospital power ,geo graphic location, teaching hospital), and psychiatrist’s data( age, gender).
Results: The number of compulsory admission decreased from 2556 patients in 2006 to 1504 patients in 2009. The two groups showed significant difference in age, being compulsory admission one year before, being voluntary admission on year before, psychosis, organic mental disorder, affective psychosis, depressive disorder, alcohol related disorders, anxiety disorder, child and adolescent disorder, insurance level, hospital level, psychiatrist’s gender and age.
The risk factors of compulsory admission in 2006 are male, psychosis, organic mental disorder, affective psychosis, alcohol related disorders, ilicit drug use, compulsory admission one year before, industrial hospital, regional hospital, local hospital, located in middle or south Taiwan and teaching hospital. The risk factors of compulsory admission in 2009 are male, psychosis, organic mental disorder, affective psycohsis, ilicit drug use, personality disorder, compulsory admission one year before, industrial hospital, regional hospital, local hospital ,located in southern Taiwan, teaching hospital and psychiatric hospital.
The risk factors of readmission in 2006 are CCIS, number of compulsory admission one year before, number of voluntary admission one year before. In 2009, personality disorder, CCIS, and number of voluntary admission one year before are risk factors.
Conclusion: The number of compulsory admission decreased after amending mental health act. It seems to protect and improve the human right and freedom.However, loss of medical treatment for the patients and care burden of family and the society need further research.
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