| Objective:To investigate the hospitalization of patients with mental illness discharged from mental hospitals in Inner Mongolia Autonomous Region in 2016,specificly analysis of general epidemiological data,discharge diagnosis,clinical medication and treatment costs of patients with mental illness,To provide a reference for mental health workers in the diagnosis and clinical use of mental illness,To provide a theoretical basis for further improving the protection system for mental patients in the Inner Mongolia Autonomous Region.Methods:We conducted a stratified random sampling of grade hospitals in the existing 18 psychiatric hospitals in our district(as of the end of 2016),six hospitals were selected according to the total ratio of 1/3.Then,from the selected hospitals,taking the month as the basic unit,the system extracts the medical records of three months in 2016(March,July,November).And the discharge diagnosis in the collected medical records must comply with the tenth edition of the International Classification of Diseases and Related Health Problems(ICD-10 for short).Also we prepared a survey record form to collect sample data,the specific data content includes: gender,age,ethnicity,marriage,education,occupation,number of days of hospitalization,discharge diagnosis,secondary diagnosis,discharge,type and dose of psychiatric drugs,The total cost of hospitalization and out-of-pocket expenses.Finally,the collected case data were sorted and analyzed.All data were analyzed statistically using SPSS22.0,taking P?0.05 as the difference was statistically significant.We use descriptive statistics to analyze general information,among them,we take the mean plus or minus the standard deviation to represent the measurement data and use analysis of variance or t test,simultaneously take the rate to represent the count data and use the chi-square test.Results:1.A total of 1646 patients with mental illness who were discharged from our district in March,July,and November in 2016 and met the ICD-10 diagnostic criteria,including 900males(54.68%)and 746 females(45.32%),the top five mental illnesses were 665 cases(40.04%)of schizophrenia,173 cases(10.51%)of bipolar disorder,126 cases(7.65%)of depressive episodes,and 125 cases(7.59%)of mental and behavioral disorders caused by alcohol use,93 cases(5.65%)of brain damage and dysfunction and other mental disorders caused by physical illness.2.The five most frequently used psychiatric drugs were 490 cases(29.75%)of risperidone,480 cases(29.16%)of olanzapine,270 cases(16.40%)of quetiapine,221 cases(13.43%)of clozapine and 198 cases(12.03%)of escitalopram oxalate,the most common two-drug regimen was 74 cases(4.50%)of risperidone combined with clozapine,the dosage of the drug was mostly within the safe dose range,and rarely overdose was used.3.In the drug use plans,754 cases(45.81%)were used alone,785 cases(47.69%)were used in combination with two drugs,105 cases(6.38%)were used in combination with three drugs,and 2 cases(0.12%)were used in combination with four or more drugs,combination drugs still account for a large proportion.4.In the adjuvant regimen,a total of 326 cases(19.81%)of benzodiazepines were used,of which 30 cases(1.82%)were single medications,among the drug use,186 cases(11.30%)of lorazepam were the most common,no combination of two or more benzodiazepines was seen.5.Among the medical payment methods,there were 1,090 cases(66.22%)of patients at their own expense and 556 cases(33.78%)of patients in medical insurance,the psychiatric disease with the highest per capita cost was schizophrenia.Conclusion:1.The most common mental diseases among the mental patients hospitalized in our district are schizophrenia and bipolar disorder,the management of these two mental illnesses should be strengthened and there is still much room for improvement in integrated hospital community management.2.New antipsychotic drugs have been widely used in the clinical treatment of psychiatry in our district,and have gradually achieved the integration with the international and domestic drug levels,and the level of diagnosis and treatment has been continuously improved.3.There are many combined medication schemes,it is necessary to strengthen the professional training of clinicians and strictly adhere to the principle of single medication.If combined medication is necessary,we should understand their compatibility contraindications and drug interactions to prevent adverse drug reactions and to promote the normalization of scientific and rational use of medicines.4.The use of benzodiazepines still occupies a certain proportion,and the management of benzodiazepines should be strengthened to prevent drug abuse.5.The medical payment method is a large proportion of patients who pay by themselves,and the per capita cost is relatively high.The relevant health finance departments should reasonably plan the financial budget for mental heath work to ensure the smooth development of mental health work. |
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