정신의료시설 입원 /입소환자의 재원 적절성 평가 도구 개발 연구

Development of Appropriateness E valuation Scale(AES) for the Psychiatric Hospitalization

In order to evaluate the appropriateness of stay whose the hospitalized inpatients in various psychiatric facilities in Korea, the authors conducted the Appropriateness Evaluation Scale(AES) which was developed by the authors and expert committee. Total 196 inpatients were evaluated ； 50 from asylums, 50 from mental hospitals, 30 from public hospitals, 38 from university hospital, 28 private clinic. Main diagnoses were schizophrenia, organic brain syndrome according to DSM-III-R. The results were followed ； 1) The initial 32 items of AES were evaluated for their significance of clinical judgement by item analysis. The result revealed that only 26 items of AES contributed to appropriateness of clinical judgement. 2) The final 26 items from item analysis were compared with appropriateness of clinical judgement through sensitivity and specificity. The sensitivity of appropriateness from AES was 100%, but the specificity was 49%. From the above results, the authors concluded that AES must be complemented the clinical judgement items for the group of inappropriateness. For the future study to conduct the appropriateness among hospitalized psychiatric inpatients, the authors recommended two stage screening method ； foil first stage screening test conducted by non-psychiatrist with 26 items of AES, and second stage of clinical evaluation by psychiatrist in terms of psychopathology