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When a schizophrenic patient is discharged from the hospital, only 4 out of 10 hospitals report this fact to the competent mental health wellness center. In the case of mentally ill patients, ongoing treatment is needed, but the connection with the community is not working properly.
Pyeong-won Shim, results of the first adequacy assessment of the second cycle of medical benefits psychiatry
Of 226, only 43% of patients with schizophrenia were notified to the area
According to the results of the first adequacy assessment of the second cycle of medical benefits psychiatry published by the Health Insurance Review and Evaluation Service on day 4, the referral rate for community service links of 226 hospitals nationwide national with records of hospitalization and discharge of schizophrenic patients from January to June of last year. It was found to be 43.3%. The referral rate for linkage to community service is the rate at which hospitals notified the director of the mental health wellness center in charge of the discharge of schizophrenic patients.
Ahn In-deuk, who committed a murder case last year. Central photo
Currently, in accordance with article 52 of the Mental Health Welfare Law, the director of a psychiatric institution, etc., can notify the director of a mental health wellness center or the director of a public health center of the discharge of a patient if the consent of the person or guardian is obtained. In particular, in the case of patients with mental illness who were admitted to the hospital due to the risk of death or suicide, or patients who were judged by a psychiatrist that there was a risk of suspending treatment after discharge, the law was revised last year to that can be notified of the discharge without their consent.
In April last year, Ahn In-deuk, who burned down an apartment in the city of Jinju, Gyeongsangnam-do, where he lived, and injured 22 victims by wielding a gun at a neighbor who was evacuating, was treated for symptoms of schizophrenia. in 2015, but it turned out that he was practically neglected after stopping treatment. . It was noted that although there was a history of harm to others, the tragedy could not be prevented because information on mental illness was not reported to the local mental health wellness center.
As a result, even though the law was revised, less than half of people with mental illness are linked to community mental health centers after discharge.
Schizophrenia is accompanied by delusions, hallucinations, altered language and behavior (strange words and actions), and emotional dullness (reduced emotional expression and motivation). Drug therapy is essential and is known to provide better therapeutic results when combined with psychosocial therapy, including psychotherapy and psychosocial rehabilitation therapy.
Experts believe that people with mental illnesses such as schizophrenia are at low risk of self-harm if early diagnosis and ongoing treatment are supported. However, if you do not receive or discontinue treatment, your symptoms will worsen and it can always lead to social problems such as Ahn Indeuk.
Results of the evaluation by indicator. Material review
Shim Pyeong-won said, “If you are connected to the Mental Health Wellness Center, you can receive support for social adjustment, such as intensive case management, rehabilitation services and family education for a certain period of time.” “It is necessary to strengthen the connection with the community for the continuous management of discharged patients. ”
Based on the results of this assessment, the “rate of daytime ward or outpatient visits within 30 days of discharge”, which can measure the degree of follow-up treatment for patients with schizophrenia and alcohol disorders, was only 38.8%. The readmission rate in the 30 days after early discharge for schizophrenic patients was 42.6%.
Patients treated for schizophrenia and alcohol disorders were hospitalized for an average of 91 days and 62 days. In 2017, it was longer than the average hospital stay at the Organization for Economic Cooperation and Development (OECD) (49 days for schizophrenia, 16 days for alcohol disorder).
In January-June of last year, the number of patients who visited the department of psychiatry due to schizophrenia and the like was 52,572 men (69.5%), approximately 2.3 times that of women (30.5%). Those over 40 and under 70 represent 6.2786 people, which represents 83.0%. Due to injury, schizophrenia (50.5%) and alcohol and drug disorders (26.5%) accounted for 8 out of 10 patients (77.0%).
Graphic = Reporter Park Kyung-min [email protected]
At assessment ▶ (treatment process) Frequency of personal psychotherapy and psychotherapy (per week) ▶ (Treatment results) Hospitalization of inpatients and discharged patients, readmission rate within 30 days of discharge, daytime visit rate to ward / outpatient and community service connection request A total of 9 indicators, including rate, obtained 66.8 points in 359 locations nationwide. The first grade was 55 locations across the country, including Seoul National University Hospital, Central Veterans Hospital, Seoul Boramae Hospital, and the National Medical Center. It is distributed in 9 in Seoul, 14 in Gyeonggi, 2 in Gangwon, 5 in Chungcheong, 10 in Jeolla, 13 in Gyeongsang and 2 in Jeju. Detailed results are published on the Shimpyeongwon website (http://www.hira.or.kr).
Ha Gu-ja, head of the evaluation department of Shim Pyeong-won, said, “We hope that the suitability evaluation will serve as an opportunity to promote the proper management of hospital treatment for patients with mental illness and return to the community. Efforts to resolve social understanding and biases are also important. ”
Reporter Hwang Soo-yeon [email protected]
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