Citation

Sugibayashi Y, Yoshimura K, Yamauchi K, Inagaki A, Ikegami N. Neuropsychiatr. Dis. Treat. 2014; 10: 1577-1584.

Copyright

(Copyright © 2014, Dove Press)

DOI

10.2147/NDT.S63009

PMID

unavailable

Abstract

BACKGROUND: In the current Japanese payment system for the treatment of psychiatric inpatients, the length of hospital stay and nurse staffing levels are key determinants of the amount of payment. These factors do not fully reflect the costs of care for each patient. The objective of this study was to clarify the relationship between patient characteristics and their care costs as measured by "care time" for patients with schizophrenia.

METHODS: Patient characteristics and care time were investigated in 14,557 inpatients in 102 psychiatric hospitals in Japan. Of these 14,557 inpatients, data for 8,379 with schizophrenia were analyzed using a tree-based model.

RESULTS: The factor exerting the greatest influence on care time was "length of stay", so subjects were divided into 2 groups, a "short stay group" with length of stay ≦104 days, and "long stay group" ≧105 days. Each group was further subdivided according to dependence with regard to "activities of daily living", "psychomotor agitation", "verbal abuse", and "frequent demands/repetitive complaints", which were critical variables affecting care time. The mean care time was shorter in the long-stay group; however, in some long-stay patients, the mean care time was considerably longer than that in patients in the short-stay group.

CONCLUSION: The results of this study suggest that it is necessary to construct a new payment system reflecting not only length of stay and nurse staffing levels, but also individual patient characteristics. © 2014 Sugibayashi et al.

Language: en

Keywords

human; cognition; violence; Japan; female; male; aged; Schizophrenia; depression; schizophrenia; anxiety; suicide attempt; article; major clinical study; anorexia; controlled study; length of stay; clinical feature; automutilation; hallucination; micturition; mental stress; treatment refusal; health care cost; daily life activity; guilt; cooperation; restlessness; disorientation; Psychiatric hospital; sexual deviation; psychosocial withdrawal; ego; gesture; euphoria; memory disorder; grandiose delusion; treatment duration; verbal hostility; communication skill; attitude to illness; eating; body posture; wandering behavior; suspiciousness; blunted affect; short term memory; very elderly; personal hygiene; independent living; water intoxication; motor retardation; Care time; Case mix; Tree-based model