Timko Christine, Sempel Jill M, Moos Rudolf H
Center for Health Care Evaluation, Department of Veterans Affairs Health Care System, Menlo Park, CA 94025, USA.
Adm Policy Ment Health. 2003 May;30(5):417-36. doi: 10.1023/a:1024693614501.
Intensive outpatient mental health programs are proliferating rapidly. However, findings suggest that intensive treatment may be no more effective than standard treatment. This study compared standard to intensive outpatient programs, within both the psychiatric and substance abuse systems of care, on organization, staffing, and treatment orientation; clinical management practices; and services. A total of 723 (95% of those eligible) Department of Veterans Affairs programs were surveyed nationwide. Psychiatric intensive programs have responded appropriately to their more severely ill patients in terms of the amount and orientation of care, and having a rehabilitation focus. However, the relative lack of basic psychiatric services in psychiatric intensive programs, and the overall similarity of substance abuse standard and intensive programs, may explain why intensive programs have not yielded patient outcomes that are superior to those of standard programs. Mental health system planners should consider differentiating intensive programs using broader criteria and methods.
强化门诊心理健康项目正在迅速增加。然而，研究结果表明强化治疗可能并不比标准治疗更有效。本研究在精神科和药物滥用护理系统中，对标准门诊项目和强化门诊项目在组织、人员配备、治疗方向、临床管理实践及服务方面进行了比较。在全国范围内对723个（占符合条件项目的95%）退伍军人事务部项目进行了调查。精神科强化项目在护理量、护理方向及注重康复方面，已对病情更严重的患者做出了适当反应。然而，精神科强化项目中相对缺乏基本精神科服务，以及药物滥用标准项目和强化项目总体上的相似性，或许可以解释为何强化项目并未产生优于标准项目的患者治疗效果。心理健康系统规划者应考虑使用更广泛的标准和方法来区分强化项目。
