Bir Ruh Sağlığı Hastanesinin 2019 ve 2020 Yılı Ayaktan Hasta Verilerinin Karşılaştırması: COVID-19 Pandemisinin Etkisi

Öz

Amaç: Bu çalışmada bir ruh sağlığı ve hastalıkları hastanesinin (RSHH) psikiyatri polikliniğine başvuran olguların sosyodemografik ve klinik değişkenlerinin incelenmesi ve karşılaştırılması amaçlanmıştır. Gereç ve Yöntem: XXX RSHH’nin ayaktan psikiyatri polikliniklerine 01.01.2019-31.12.2019 ve 01.01.2020-31.12.2020 tarihleri arasında başvurmuş bütün olgular çalışmaya dâhil edilmiştir. Olgulara ait yaş, cinsiyet ve tanı gibi sosyodemografik ve klinik veriler kaydedilmiştir. Bulgular: 01.01.2019-31.12.2020 arasında başvuran olgu sayısı 108.367 (2019’da 71280, 2020’de 37087) idi. Totalde ortalama yaşı 44.79±17.62 yıldı (2019’da 45.18±17.78 yıl, 2020’de 44.03±17.28 yıl). Totalde kadın ve erkek olguların yaşları arasında anlamlı farklılık vardı (p<0.001) ve olguların %75.1’i XXX’da ikamet ediyordu. Totalde olguların %85.9’u muayene, %4.6’sı tek hekim raporu, %5.1’i sağlık kurulu raporu ve %4.4’ü denetimli serbestlik nedeniyle başvurmuştu. Totalde cinsiyetler arasında başvuru nedeni, tanı, ayaktan muayene sonrası yatış ve sağlık güvencesi açısından farklılık saptandı (p<0.001). Totalde, en sık başvuru tanıları sırasıyla anksiyete bozuklukları spektrumu (%21.6), şizofreni spektrum bozuklukları (%19.4), depresyon spektrum bozuklukları (%15.6) ve bipolar spektrum bozukluklarıydı (%12.5). Yatırılan olgularda adli giriş oranı, ikamet ve tanı yatırılmayanlardan anlamlı olarak farklıydı (p<0.001). Adli girişlerin %94’ü erkekti, %55.9’u denetimli serbestlik amacıyla başvurmuştu, %58.5’i alkol ve madde kullanım bozukluğu tanısı almıştı, Sağlık kurulu için başvuranların %87.7’si genel psikiyatrik muayene tanısı almıştı. Totalde, XXX dışında ikamet edenlerde bipolar spektrum bozukluğu ve şizofreni spektrum bozukluğu oranı daha yüksek iken XXX’da ikamet edenlerde anksiyete bozukluğu spektrumu ve depresyon spektrum bozukluğu daha yüksekti (p<0.001). Sonuç: COVID-19 salgını bir RSHH’nin ayaktan psikiyatri kliniğine başvuran olguların sayısının belirgin olarak azalması ile ilgili bulunmuştur. Ayrıca 2019 ve 2020 yıllarında başvuran olgular arasında sağlık güvencesi, başvuru nedeni, tanı ve hastaneye yatış açısından da COVID-19 ile ilişkilendirilen çeşitli farklılıklar görülmüştür.

Anahtar Kelimeler

• Ayaktan hasta
• Adli olgu
• Yatış
• Denetim
• COVID-19
• Pandemi

Comparison of 2019 and 2020 Outpatient Data of a Mental Health Hospital: The Impact of the COVID-19 Outbreak

Abstract

Aim: In this study, it was aimed to examine and compare the sociodemographic and clinical variables of the subjects admitted to the outpatient psychiatry clinic of a mental health and diseases hospital (MHDH). Material and Method: All subjects who admitted to the outpatient psychiatric outpatient clinics of XXX MHDH between 01.01.2019-31.12.2019 and 01.01.2020-31.12.2020 were included in the study. Sociodemographic and clinical data of the subjects, such as age, gender, and diagnosis, were recorded. Results: The number of subjects admitted between 01.01.2019-31.12.2020 was 108,367 (71,280 in 2019; 37,087 in 2020). The total mean age was 44.79±17.62 years (45.18±17.78 years in 2019, 44.03±17.28 years in 2020). In total, there was a significant difference between the ages of male and female subjects (p<0.001) and 75.1% of the subjects resided in XXX. In total, 85.9% of the subjects were admitted due to examination, 4.6% due to a single physician report, 5.1% due to medical board report, and 4.4% due to probation. Overall, there were differences between genders in terms of admission reason, diagnosis, hospitalization after outpatient examination, and health insurance (p<0.001). In total, the most common diagnoses were anxiety disorders spectrum (21.6%), schizophrenia spectrum disorders (19.4%), depression spectrum disorders (15.6%), and bipolar spectrum disorders (12.5%). Forensic health insurance, residence, and diagnosis in hospitalized subjects were significantly different from those who were not hospitalized (p<0.001). Ninety-four percent of the forensic admissions were male, 55.9% admitted for probation, 58.5% were diagnosed with alcohol and substance use disorder, 87.7% of those who admitted for the medical board report were diagnosed with a general psychiatric examination. In total, the rates of bipolar spectrum disorder and schizophrenia spectrum disorder were higher in those residing outside XXX, while anxiety disorder spectrum and depression spectrum disorder were higher in those residing in XXX (p<0.001). Conclusion: The COVID-19 outbreak was associated with a significant decrease in the number of subjects admitted to the outpatient psychiatric clinic of an MHDH. In addition, there were various differences associated with COVID-19 in terms of health insurance, admission reason, diagnosis, and hospitalization between the subjects admitted in 2019 and 2020.

Keywords

• Outpatient
• Forensic case
• Hospitalization
• Probation
• COVID-19
• Pandemic

Kaynakça

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