| Objects:1.From the hospital point of view,compare the composition and spending of inpatient care of schizophrenes between psychiatry department of polyclinic and insane hospital,and compare the cost of inpatient care schizophrene among different group of course.2.To investigate the related factors of quality of life of hospitalized schizophrenes when they check in hospitals.3.To compare the therapeutic efficacy between the two different hospitals of hospitalized schizophrenes and do cost and effectiveness analysis;To compare the therapeutic efficacy among different course groups of hospitalized schizophrenes and do cost and effectiveness analysis.4.To approach the methods that decrease therapeutic cost and improve therapeutic efficacy of hospitalized schizophrenes.Methods:1.A comparative study was carried out about schizophrenes between the Psychiatry Department of polyclinic(75) and the insane hospital of Yunnan province(112),187 patients were picked.And these 187 patients were divided to four groups form their course:first episode group,the group less than 5 years,the group from 5 years to 10 years,the group more than 10 years.The International Statistical Classification of Disease and Related Health Problem(ICD-10) was adopted as diagnosis criteria.Investigate the demography characteristics and Previous Treatment situation by self-designed general condition investigation scales;Collate and analyze the expense of hospitalization and treatment by self-designed hospitalization cost investigation scale,And at last take the expense Collated by the computer to be the consumed cost of hospitalization and treatment.2.The schizophrenes were assessed with PANSS,WHOQOL-BREF during the first three days of hospitalization, investigators would carry out a baseline survey about PANSS and WHOQOL-BREF; when schizophrenes discharged from the hospital,investigators assessed them again; use the score Changes in the results ofPANSS,WHOQOL-BREF,and the combined effect of them to be the effectiveness of therapy,and carry out cost and effectiveness analysis.3.Use the method of one-factor analysis of variance and Step by step linear regression analysis to analyze the coherent factors of schizophrenes' quality of life when they were hospitalized.Reasults:1.There was no significant difference about the demography characteristics of schizophrenes between the two hospitals,including age,sex, marriage,ethnicity,education level,place of residence,medical insurance;There was a significant difference among the four different course groups of schizophrenes in aspects of age,marriage and medical insurance.2.The total cost on treating schizophrenes in Psychiatry Department of polyclinic is significant lower than insane hospital.On the constitution of cost,the part of Drug Cost of Psychiatry Department of Polyclinic is significant higher,it already exceed 40%.But in insane hospital,the biggest part of cost was Treatment Cost,it occupied nearly 43%.The total cost had no significant difference between first episode group and the group less than 5 years.But accompanying the growth of course,the group from 5 years to 10 years,and the group more than 10 years showed that the total treatment cost obviously increased by degrees.3.The coherent factors of schizophrenes 'quality of life is the total score of PANSS and drug side effects,the outcome shows:age,marriage,education et.al were not significantly related with the quality of life of schizophrenes.4.when the improvement of quality of life or psychotic symptom,or general effect of this two aspects were taken to be the effectiveness of therapy the C/E of Psychiatry Department of polyclinic is significant lower than insane hospital;From low to high,The C/E of four different groups of disease course of schizophrenes were: First episode group,the group less than 5 years,the group from 5 years to 10 years, the group more than 10 years.Conclusions:1.From the hospital point of view,the total cost to treat schizophrenes in Psychiatry Department of polyclinic was significant lower than insane hospital.The time schizophrenes hospitalized in Psychiatry Department of polyclinic was much shorter than insane hospital.This induced that schizophrenes in insane hospital spended more bedspace fees,care and treatment cost,so it led to a higher total cost of threatment;Accompanying the addition of disease course,the cost of hospitalization schizophrenes showed a trend of going up.2.The quality of life of schizophrenes mainly related to PANSS total score,drug side effects when they were hospitalized,this showed:with more PANSS total score and more drug side effects, the quality of life of schizophrenes would be worse.The quality of life of schizophrenes had no significant relevance with Sex,age,nationality,place of residence and family income when they were hospitalized.3.The threatment of schizophrene cost/effectiveness showed that C/E of schizophrenes in Psychiatry Department of polyclinic is lower than schizophrenes in insane hospital.On one hand,this illustrated Psychiatry Department of polyclinic had superiority of using medical resources;on the other hand,it also illustrated that insane hospitals maybe shoulder the functions of treating more patients with refractory schizophrenia.And from length of staying in hospital,the insane hospitals group was much longer than the group of Psychiatry Department of polyclinic,this reflected that insane hospital maybe shouldered some functions of convalescence and rehabilitation of port management.4.The C/E were significant difference among the groups of different course of hospitalized patients with schizophrenia,With the increasing course of the disease,their C/E showed an increasing trend,this illustrated that accompanied by an increasing course of schizophrenes,their expense of hospitalization also had a corresponding addition,and their difficulty of treatment maybe gradually increased. So,it has a big Significance to treat schizophrenes systematically and complete in early course.And after that we should pay our attention on prevention of repeated attacks and Re- hospitalized.
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