Comparative Study between the Quality Management Indicators Marker of Major Psychiatric Disorders in Evolution

摘要

Indicators of quality management are represented by: accounting hospitalization days (duration of stay); mortality rate; the rate of nosocomial infections; patients readmitted in 30 days; the percentage patients transferred; inconsistent diagnoses. The hospitalization period is a marker of evolution. The present study reflects comparative data between duration and the number of hospitalisations in patients with major psychiatric disorders. Introduction. Medical Psychiatry as a discipline has developed a specialized approach in the treatment of mental diseases, a phenomenon linked to the progress of knowledge ofpsychopathology and the increasing complexity of methods of diagnosis and treatment. The history of psychiatric patients reflects not only changes in scientific understanding of mental disorder, but also the beliefs of political, social and economic interests of that period [1,2]. Objectives. We analised the duration and number of hospitalisation in patients with schizophrenia, psychotic disorders compared to those with bipolar disorder and major depressive disorder in Psychiatric clinic from Craiova between 2006-2010. Method. Retrospective study during 2006-2010 took into account 8234 patients aged between 20-65 years from the Psychiatric Clinic Craiova constituting four groups: group N1=989 patients belonging to the schizophrenia group; group N2=1222 patients with psychotic disorders, group N3=918 patients with bipolar disorder and group N4=5101 with major depressive disorder.For data processing we used Microsoft Excel (Microsoft Corp., Redmond, WA, USA), together with the suite for MS Excel XLSTAT (Addinsoft SARL, Paris, France) and IBM SPSS Statistics programme 20.0 (IBM Corporation, Armonk, NY, USA). Results. Schizophrenia being defined as a chronic disease was noted that 85.4 % of the patients from the first group received at least two admissions during the trial. Females have better prognosis, having a lower share in the group with multiple hospital admissions. The duration of the stay was longer than two weeks for 61,7% in the N1 group. Group N2 patients, bipolar disorder, have received at least two admissions, the share between the sexes is similar, the duration of hospitalisation not exceeding 7 days for 54,2% of patients with bipolar disorder. Women with more than 14 hospitalisation days had a share of 21.6%. Duration of hospitalization with the N3 group was of maximum two weeks at 71,4%, the group of major depressive disorders N4 had a number of short admissions of 44,4%. Conclusion. Statistically significantly high differences (p =0,000233<0.001) in favor of the schizophrenia and psychotic disorders group compared with the group of disorders of affectivity, in terms of the number and the duration of hospitalizations, marker of the evolution on the long term.