| Project/Area Number |
16K09182
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Multi-year Fund |
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| Section | 一般 |
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| Research Field |
Medical and hospital managemen
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| Research Institution | Jichi Medical University |
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Principal Investigator |
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| Co-Investigator(Kenkyū-buntansha) |
齋藤 暢是 自治医科大学, 医学部, 助教 (60742864)
須田 史朗 自治医科大学, 医学部, 教授 (40432207)
塩田 勝利 自治医科大学, 医学部, 准教授 (40398516)
安田 学 自治医科大学, 医学部, 講師 (40468343)
齋藤 慎之介 自治医科大学, 医学部, 講師 (40726288)
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| Project Period (FY) |
2016-04-01 – 2020-03-31
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| Project Status |
Completed (Fiscal Year 2019)
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| Budget Amount *help |
¥2,470,000 (Direct Cost: ¥1,900,000、Indirect Cost: ¥570,000)
Fiscal Year 2018: ¥650,000 (Direct Cost: ¥500,000、Indirect Cost: ¥150,000)
Fiscal Year 2017: ¥650,000 (Direct Cost: ¥500,000、Indirect Cost: ¥150,000)
Fiscal Year 2016: ¥1,170,000 (Direct Cost: ¥900,000、Indirect Cost: ¥270,000)
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| Keywords | 精神科病院 / 身体合併症 / 認知症 / 統合失調症 / 肺炎 / 終末期医療 / 院内死亡 / 生活習慣病 / 死因 / 高齢化 / 器質性精神病害 / 単科精神科病院 / 死亡診断書 / 入院患者の高齢化 / 精神医療 |
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| Outline of Final Research Achievements |
In a 20-year retrospective death certificate survey at psychiatric hospitals, data from 16 hospitals were obtained. It was confirmed that the main causes of death were respiratory diseases, mainly pneumonia, and then cardiovascular diseases. However, many psychiatrists are not familiar with how to write death certificates when a patient is hospitalized for dementia and died of pneumonia: the cause of death should be dementia. There are many medical certificates without mention of psychiatric diagnosis. For this reason, most cases of pneumonia were considered dementia, however the details could not be determined. A two-year prospective survey allowed 19 hospitals to be surveyed. The cause of death was respiratory disease in 39%, cardiovascular disease in 29%, and malignant neoplasm in 10%. Psychiatric diagnoses accounted for 64% of schizophrenia and only 12% of dementia.
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| Academic Significance and Societal Importance of the Research Achievements |
院内死亡をすべて調査した20年間の後方視的死亡診断書調査では、認知症の看取りが多いことが示唆されたが、3年以上の長期入院に限った2年間の前方視的調査では、認知症は1割程度だった。ここから推測されることは認知症の終末期を精神科病院が担っている可能性があることである。認知症患者の在宅での看取りが可能になるような対策が必要であろう。他方、精神科病院長期入院の患者の死亡は、依然、統合失調症が多くを占めており、慢性期統合失調症患者の呼吸器感染防止、循環器疾患の早期発見などの院内対策が必要であることが示唆された。
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