ABSTRACT
Objective To identify the efficiency of 13 adult psychiatric hospitals under the MentalHealth Department.Materials and methods This retrospective research paper was collected data fromthe budget year 2008 consisting 5 input factors (personnel costs, operating cost fromgovernment budget, operating costs from hospital profit, number of beds, and number of hospitalofficials) and 4 output factors (number of outpatients, number of inpatients, length of stay,and a mean of relative weight of Diagnosis Related Group showing the complexity level oftreatment of each particular patient). Then these input and output data were analyzed by usingdata envelopment analysis (DEA) technique.Results The results, by constant return to scale (CRS) showed that 9 out of 13hospitals were on the overall efficiency frontier having an average CRS of 0.954. Variablereturn to scale (VRS) showed that there were 11 hospitals on the technical efficiency frontierwith an average VRS of 0.972.Conclusion There were 9 psychiatric hospitals having high overall efficiency and11 psychiatric hospitals having high technical efficiency. However, there were some limitationsin some specific areas in psychiatric hospitals.Key words : efficiency, data envelopment analysis (DEA) model, psychiatric hospital
ABSTRACT
Objective To develop a psychiatric trigger tool on identifying adverse eventin Thai psychiatric patients and develop risk identifying system using trigger tool.Materials and methods Trigger tool was developed by the multidisciplinaryteam based on triggers of Harvard Medical Practice Study (HMPS). Data were collectedfor 15 trigger indicators from 9 sources. After pilot trial in Suanprung Psychiatric Hospitaland harmonization training for multidisciplinary teams from 7 participated psychiatrichospitals, a cross-sectional medical record review was conducted to identify adverseevents in medical record of the patients who were discharged from 7 psychiatric hospitalduring October 2007.Results Four hundred twenty two medical records were reviewed. The totalpatients-days were 97,745 days. Three hundred fifty three adverse events were identifiedwith mean rate of 5.1 per 1,000 patients days or 24.6 per 100 patients. The first threetriggers that detected most adverse events are; antibiotic receiving trigger, infection inhospital and unplanned readmission with the same diagnosis within 28 days respectively.Conclusion Psychiatric trigger tool can be used to detect adverse events moreeffectively in psychiatric patients. However, for efficiency, only the highly sensitivetrigger indicators which supported by the convenient retrievable completed data sourcesshould be used.Key words : adverse event, psychiatric, trigger tool