Barbato A, Terzian E, Saraceno B, Montero Barquero F, Tognoni G
Centro Psicosociale, Unità Operativa di Psichiatria Policlinico II, Milano, Italy.
Soc Psychiatry Psychiatr Epidemiol. 1992 Jan;27(1):46-52. doi: 10.1007/BF00788956.
This is the first of a series of papers presenting the results of an Italian collaborative study on psychiatric inpatient service utilisation. Patterns of care of a large sample of patients discharged after short inpatient treatment are discussed in the light of the changes introduced by the 1978 Mental Health Act in the Italian psychiatric care delivery system. Three closely related issues are considered: a) use of psychiatric hospitalisation, b) relationships between inpatient and community treatment before and after an admission episode, c) continuity of care. The main findings are: 1) great variability between services suggests that local factors play an important role in determining the contents of care in Italian post-reform psychiatry. 2) The relationship between inpatient and community services is complex, partial integration being the most common picture. 3) Psychiatric hospitalisation is the entry point into the care system for a sizeable group of patients. 4) Continuity of care is achieved for half the patients, mostly with diagnoses of severe mental disorders. 5) Subjects with a recent history of revolving door behaviour or a past history of mental hospital admission show the highest likelihood of remaining in community care following discharge.
这是一系列论文中的第一篇，介绍了一项关于意大利精神科住院服务利用情况的合作研究结果。根据1978年《精神卫生法》给意大利精神科护理提供系统带来的变化，讨论了经过短期住院治疗后出院的大量患者的护理模式。考虑了三个密切相关的问题：a）精神科住院治疗的使用情况；b）入院前后住院治疗与社区治疗之间的关系；c）护理的连续性。主要研究结果如下：1）各服务机构之间存在很大差异，这表明当地因素在决定意大利改革后精神病学护理内容方面发挥着重要作用。2）住院服务与社区服务之间的关系很复杂，部分整合是最常见的情况。3）精神科住院治疗是相当一部分患者进入护理系统的切入点。4）一半的患者实现了护理的连续性，这些患者大多被诊断患有严重精神障碍。5）近期有“旋转门”行为史或过去有精神病院住院史的患者出院后留在社区护理中的可能性最高。
