The Exploration of Characteristics and Related Factors for Patients with Severe Mental Illness who Received Compulsory Admission before and after the 2007 Amendment Mental Health Act in Taiwan.

• Main Authors: Yi-Chen Chen, 陳羿禎
• Other Authors: Huang-Chih Chou
• Format: Others
• Language: zh-TW
• Published: 2016
• Online Access: http://ndltd.ncl.edu.tw/handle/55094727720623090611

碩士 === 美和科技大學 === 健康照護研究所 === 104 === Purpose: The Mental Health Act was amended in 2007. And to an evaluation by two designated certificated psychiatrists, whether a patient requires compulsory admission will also be reviewed and decided by the Mental Illness Mandatory Assessment and Community Treatment Review Committee. The main purpose of characteristics and related factors for patients with severe mental illness who received compulsory admission before and after the 2007 amendment Mental Health Act in Taiwan. This research investigated the number of compulsory hospitalization, the patient's property, length of stay, readmission rates and medication adherence, etc., and to further understanding of influence causes and predictive risk factors. Method: This research used the National Health Insurance Research Database (NHIRD) of mental illness inpatient files for the study data. The data divided in 2006 and 2011 accepted by the study group and the control group in the number of compulsory hospitalization cases or not with case-control (1:4) by sex and gender. Analysis was there any significant difference from medication characteristics, patient characteristics, hospital characteristics, medication adherence and different health care utilization results. And then used the Kaplan-Meier method to estimate the survival curve and the multivariate Cox proportional hazards regression model to identify risk factors. Results: The relevant data analyzed of the compulsory admission patients before and after the amended Mental Health Act were gender, diagnosis, CCIs, Acute hospital days, hospital levels, hospital power, location of hospitals, teaching hospital, physician gender and age. The patients’ readmission rate dropped from 52.6 to 42.5 percent. The study of readmission has been in decline. Compulsory admission of patients were with longer average social survival time after the amended Mental Health Act. The hospitalization expenses of compulsory admission were higher than voluntary admission. More complications of their disease and the number of acute length of stay less had high medical expenses relatively, and Schizophrenic patients were relative to have low medical expenses of other diagnosis. The risk factors of rehospitalization in 2006 were acute hospitalization over 60 days, type 4 insurance, located in middle and south, admission one year before, OPD one year before, MPR. The risk factors of rehospitalization in 2011 were CCIs, admission one year before, MPR. Conclusions: This study results revealed very important information, and the effectiveness and impact of changes. The future can be used to provide mental health care system policies.