Schreter R K
Sheppard Pratt Health Plan, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Psychiatr Clin North Am. 2000 Jun;23(2):335-46. doi: 10.1016/s0193-953x(05)70163-5.
Many of the components of the continuum originated in legislation that created the community mental health centers. The continuum grew in breadth and depth with the arrival of managed care because it offered less expensive ways to satisfy patient needs. Over the past decade, days spent in hospital have decreased from more than 100 per thousand individuals in some health plans to less than 20 for the same populations. Greatly reduced rates of admission and shortened lengths of stay made this decrease possible. But simply being quicker and cheaper is not good enough. To fulfill their promise, the components of the continuum and the larger delivery systems must provide care that is of superior quality and outcome. An important next step in the evolution of the continuum will be to generate the data that will make it possible to evaluate program performance, compare treatment alternatives, and usher in an era of evidence-based mental health care.
连续统一体的许多组成部分起源于创建社区心理健康中心的立法。随着管理式医疗的到来，连续统一体在广度和深度上都有所发展，因为它提供了更便宜的方式来满足患者需求。在过去十年中，某些健康计划中每千人住院天数已从超过100天降至同一人群的不到20天。入院率大幅下降和住院时间缩短使得这种减少成为可能。但仅仅更快、更便宜是不够的。为了兑现承诺，连续统一体的组成部分和更大的医疗服务系统必须提供质量和效果上乘的护理。连续统一体发展的一个重要的下一步将是生成数据，以便能够评估项目绩效、比较治疗方案，并开创循证心理健康护理的时代。
