Epidemiology of schizophrenia and risk factors of schizophrenia-associated aggression from 2011 to 2015.

Objective To investigate the risk factors associated with aggression in patients with schizophrenia. Methods Patient clinical, behavioural, and demographic information was collected and reported online to the Beijing Mental Health Information Management System by psychiatrists. We used chi-square tests to analyse information between 2011 and 2015 to determine the prevalence and incidence of schizophrenia and the rate of aggression. We used univariate and binary logistic regression to analyse risk factors of aggressive behaviours. Results The prevalence and incidence of schizophrenia, and the proportion of cases displaying aggressive behaviour, increased considerably from 2011 to 2015. Risk of aggression was associated with non-adherence to medication (odds ratio [OR]: 2.92; 95% confidence intervals [CI]: 2.08-4.11), being unmarried (OR: 1.62; 95% CI: 1.03-2.55), having physical disease (OR: 3.26; 95% CI: 2.28-4.66), and higher positive symptom scores (OR: 2.01; 95% CI: 1.06-3.81). Physical disease was a risk factor associated with committing more than one type of aggression. Conclusion We confirmed that demographic factors, treatment-related factors, and clinical symptoms were associated with aggression in patients with schizophrenia in Beijing. A focus on improving controllable factors, including medication adherence and physical health status, might help to prevent aggressive behaviour.

Relationship preferences and experience of primary care patients in continuity of care: a case study in Beijing, China.

BACKGROUND: Continuity of care can bring a wide range of benefits to consumers, providers and health care systems. This study aimed to understand the relationship preferences of primary care patients and their associations with patient experience of continuity of care. METHODS: A questionnaire survey was conducted on 700 patients who sought medical care from a community health organisation in Beijing. The survey contained four items examining the relationship preferences of the respondents, and a modified Questionnaire of Continuity between Care Levels (CCAENA) measuring patient experience of continuity of care based on a three dimensional (relational, informational and managerial) model. The associations between the relationship preferences and the experience of respondents in continuity of care was tested using a linear regression model controlling for age, sex, education, medical insurance, personal income and servicing facilities. RESULTS: The respondents experienced relatively lower levels of informational and managerial continuity compared with relational continuity of care. More than 80% of respondents preferred free choice and a continuing relationship with doctors, compared with 59% who endorsed community facility control over hospital appointments. A preference for a continuing relationship with doctors was associated with all aspects of continuity of care. A preference in favour of community facility control over hospital appointments was a strong predictor of managerial continuity (ß = 0.333, p < 0.001) and informational continuity (ß = 0.256, p < 0.001). Patient preference for free choice of doctors was positively associated with relational continuity with specialists (p < 0.001), but not with primary care providers (p > 0.08). Perceived importance of information exchange was associated with relational and managerial continuity (p < 0.05), but not with informational continuity (p = 0.34). CONCLUSIONS: Patients prefer a high level of freedom of choice and sustained individual relationship with doctors. Relationship preferences of patients are associated with their experience of continuity of care. But patient strong preference for free choice of doctors is not aligned with relational continuity with primary care, a desirable feature of cost-effective healthcare systems.