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2008년도 서울시 정신보건심판위원회의 계속입원심사 및퇴원청구심사 현황
나리지(Riji Na),제수경(Sukyung Je),이명수(Myung-Soo Lee),이광자(Kwang-Ja Lee),권정화(Junghwa Kwon),홍진표(Jin Pyo Hong) 대한사회정신의학회 2011 사회정신의학 Vol.16 No.1
연구목적 : 본 연구의 목적은 2008년에 서울시 정신보건심판위원회에 청구된 계속입원심사와 퇴원청구심사의 특성과 심사 결과를 살펴봄으 로써 향후 서울시 정신보건정책을 수립하기 위한 정책자료를 수집하는 것을 목적으로 하였다. 방 법 : 2008년 1월 1일부터 12월 31일까지 서울시 정신보건심판위원회에 신청된 계속입원심사 및 퇴원청구심사 서류에 나와 있는 자료를 기술분석 하였다. 결 과 : 연구 기간 동안 서울시 정신보건심판위원회에 청구된 계속입원심사는 1213건으로 803명의 환자에서 심사가 청구되었다. 퇴원청 구심사는 73건으로 73명의 환자에서 심사가 있었다. 계속입원심사를 청구한 환자들의 대부분은 의료급여 1종이었다. 또 803명의 환자들 중 44.5%가 구청장을 보호자로 두고 있었으며 85.7%에서 정신분열증이나 분열정동장애가 1차 진단명이었다. 퇴원청구심사를 시행한 환자들의 경우에는 대부분 의료급여를 제외한 일반 건강보험가입자였다. 심판위원회의 심사 이후 퇴원이 결정된 비율은 계속입원심사의 경우 4.9%, 퇴원청구심사의 경우에는 12.0%였다. 결 론 : 계속입원심사를 청구하는 것과 관계가 있는 것으로 보이는 요인들은 의료급여 1종, 정신분열증이나 분열정동장애 진단, 구청장이 보호자로 있는 경우 등이었다. 반면에 퇴원청구심사를 청구한 환자들은 대부분 의료급여를 제외한 일반 건강보험가입자들이었다. 의학적으로 반드시 필요한 경우를 제외한 장기 입원을 줄이고 환자들의 인권을 보호하기 위해서는 지지체계가 약하고 만성적인 질환을 가지고 있는 환자들을 대상으로 한 정책이 필요하다. Objectives : The purpose of this study was to evaluate the current situation about requested judgments of the proprieties for extension on hospitalization and discharge on Seoul Mental Health Review Board and the results of them. Methods : The data was collected from cases had been examined by Seoul Mental Health Review Board from Jan. 1 to Dec. 31 of 2008. Results : 1213 cases to judge the proprieties for extension on hospitalization and 75 cases for discharge were examined. Most patients requested judgments of the proprieties for extension on hospitalization had Medicaid type I. Guardian of 44.5% of patients requested judgments of the proprieties for extension on hospitalization was head of a gu and diagnosis of 85.7% of these patients was diagnosed as schizophrenia or schizoaffective disorder. Most patients requested discharge corresponded to Medical insurance. 4.9% of cases for judgments of the proprieties for extension on hospitalization and 12.0% of cases for discharge were ordered to discharge. Conclusion : Factors related to requested judgments of the proprieties for extension on hospitalization are Medicaid type I, diagnosis of schizophrenia or schizoaffective disorder, guardian of head of a gu. More than half of the patients requested discharge participated in medical insurance. To reduce the period of hospitalization, there should be active policies for the patients with weak support system and chronic and severe mental disorders.
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박승진,임아영,박수빈,나리지,홍진표,Park, Sung-Jin,Lim, Ayoung,Park, Subin,Na, Riji,Hong, Jin Pyo 대한불안의학회 2013 대한불안의학회지 Vol.9 No.1
The increasing suicide rate is a serious problem in Korea. Because of increased awareness of suicidality as a problem and because completed suicide is the fourth leading cause of death, it is very important to assess the risk of suicide. The purpose of this review is to provide a systematic examination of predictive validity of measures of suicidal ideation and behavior. A number of instruments are described as useful for identifying individuals "at high risk" for suicidal behavior. However, the predictive validity for most suicide measures has not been established. The present review only includes suicide assessment instruments with published predictive validity. In addition to evaluating the suicide assessment with respect to predictive validity, the present review describes and summarizes the psychometric properties of each measure. In conclusion, because of the complexity of studying the risk of suicide and the paucity of well-designed studies, it is extremely difficult to compare and generalize these findings. In addition, only a few instruments, such as the Scale for Suicide Ideation, Suicide Intent Scale and the Beck Hopelessness Scale, have been found to be significant risk factors for completed suicide. Another problem in the field involves that there have been few suicide measures designed for elderly populations. Clearly, future research is needed to investigate the predictive validity of standardized measures for completed suicide, especially targeting elderly populations.
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이유진,용효중,김건우,나리지,이기경,황태연,이종국,홍진표 대한생물치료정신의학회 2011 생물치료정신의학 Vol.17 No.2
Objectives:Since the order for medical treatment as outpatient has begun in Korea, there have been no requests due to the absence of specific details relating to its enforcement and lack of understanding of related specialists. We reviewed current guidelines and administrative conditions for order for medical treatment as outpatient in Korea, and examined examples of operation and related regulations of developed countries. Methods:Korean studies concerning development of the order for medical treatment as outpatient were inquired. We investigated the guidelines of other countries including U.S.A., Australia, United Kingdom and Canada. The survey of related specialists for the improvement of order for medical treatment as outpatient was performed. Results:Related specialists agreed that current order for medical treatment as outpatient needed more detailed guidelines for candidate patients, processes and management for noncompliance. Additionally, majority of the specialists suggested that candidates for order for medical treatment as outpatient should be extended for not only hospitalized patients but also patients in community. Conclusions:We reviewed detailed considerations regarding candidate recipients within current legislation, complemented post-enforcement report, management procedures, and stipulated actions for noncompliance, to be used as practical guidelines for application. More fundamental measures than complementation of guidelines, such as modification of related legislature will be needed to increase usage, and further details with reference to confidentiality of recipients and safety measures and financial support of treatment personnel will be needed.
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