A Study on the Judgement for Hospitalization of the Mental Health Judgement Boards / 신경정신의학

ABSTRACT

OBJECTIVES: This study was to analyze the results of judgement on continuing hospitalization by the Mental Health Judgement Boards and to explore the present status of judging system for continuing hospitalization. METHODS: Analyzing summary and request sheets for continuing hospitalization on August 2001, we compared the number of requests for continuing hospitalization and the dissent rate at each Mental Health Judgement Board. The selationship between dissent rate and clinical characteristics such as diagnoses, caregivers, medical care systems, institute, and the clinical state was also explored. RESULTS: The summary sheets on the judgement for continuing hospitalization from 14 Mental Health Judgement Boards were collected. Total number of the requests for continuing hospitalization was 4,853 and the nationwide dissent rate was 4.2% with broad range of 0 to 32% in each Mental Health Judgement Board. The request sheets from 10 Mental Health Judgement Boards were 3,014. The proportion of schizophrenic patients was 73.0%, followed by 9.1% for alcoholics, 4.1% for mentally retarded patients, 3.8% for dementic patients, and 10.5% for others. The different of the dissent rates of schizophrenia (2.9%) and other non-schizophrenia (4.8%)was statistically signiticant (chi2=6.797, p=0.009). The dissent rates of family members (4.0%) and majors (1.6%) were statistically different (chi2=10.294, p=.001). The dissent rates of mental hospitals (3.8%) and mental health welfare facilities (2.1%) were statistically different (chi2=5.483, p=.019). The dissent rates of medicaid (3.5%) and insured (1.7%) was statistically different (chi2=4.622, p=.032). The dissent rates by the severity of clinical status were statistically different in all six categories the risk for self-injury or injuring others (chi2=66.507, p=.000), the disability of daily self-care (chi2=136.033, p=.000), odd, eccentric, or regressed behavior (chi2=96.558, p=.000), unreal or illogical thought pattern (chi2=122.988, p=.000), negativism (chi2=62.715, p=.000), and memory, orientation or judgement problems (chi2=38.387, p=.000). CONCLUSION: The nember of requests for continuing hospitalization and the dissent rates showed wide variations among Mental Health Judgement Boards. Also, the dissent rates of the Boards were significantly different according to diagnoses, caregivers, medical care systems, institute, and the clinical status of patients. This result suggests that the standardization of the guideline on the judgement for continuing hospitalization and the practical plans for protecting human rights of patients require thorough preparation.