綜合醫院老年住院精神病患之分析

Characteristics of Elderly Patients Admitted to the Psychiatric Ward of a General Hospital

蔡世仁(Shih-Jen Tsai) ； 黃正平(Jen-Ping Hwang) ； 沈楚文(Cho-Boon Sim)

《The Kaohsiung Journal of Medical Sciences》 11卷8期 (1995/08) Pp. 453-457

https://doi.org/10.6452/KJMS.199508.0453

摘要

近幾十年來國內老年人口的急速增加，使得老人精神問題日益重要。本研究以五年內滿65歲精神科住院病患為樣本，探討老人住院精神病患的特質，並與非老人病患及國外報告作比較，以期作為老人醫療政策的參考。樣本數共計524人次；診斷以器質性精神症最多，特別是癡呆症及譫妄；平均住院天數為26.7天，較國外為短，與年輕住院患者相近；出院時有九成達到改善。這些結果顯示老人精神病患特別需要詳細檢查以排除器質性因素；而有合適轉介機構可避免長期住院；經過短期精神科住院，患者大都能得到改善，可減少照顧者的困擾或是轉送慢性機構。

並列摘要

The rapid growth of the over 65 population in Taiwan during recent decades has brought into focus the planning to provide health care for aged citizens. It is generally agreed that the incidence of mental disorders rises with age. With the stress on rapid treatment and early return to community, the concept of short-term hospitalization for the gerosychiatric patients has become more accepted. In this study we examined characteristics, diagnostic classification and treatment outcomes of 524 consecutive patients (age≥65) admitted to the geropsychiatric unit of a general hospital over a 5-year period.
Results demonstrated that 45.9% of the patients had organic mental disorders. Among them, almost half of the patients were diagnosed as having dementia; delirium was the second most common diagnosis. The average length of stay was 26.7 days for all patients and it was not affected by diagnostic subtype. No significance was found in the length of stay between the geropsychiatric inpatients and the other psychiatric inpatients. Outcomes measure showed favorable response to hospitalization in most of these patients.
These data suggested that there is a specific diagnostic distribution in the geropsychiatric inpatients. Rigorous organic work-up in these patients is necessary to rule out organic problems. The favorable response after short-term hospitalization indicated the restorative and rehabilitative functions of the general hospital geropsychiatric care. The hospital’s fears of being burdened with a chronic population could be lessened with a suitable referral system. Further study is needed to explore whether early geropsychiatric intervention may obviate the need for admission or reduce the length of stay.

並列關鍵字

aged ； geropsychiatric ； inpatient