Udechuku Adaobi, Olver James, Hallam Karen, Blyth Frances, Leslie Melissa, Nasso Marina, Schlesinger Paul, Warren Lorraine, Turner Miles, Burrows Graham
North East Mobile Support and Treatment Service, Austin Health, Heidelberg, Vic., Australia.
Australas Psychiatry. 2005 Jun;13(2):129-34. doi: 10.1080/j.1440-1665.2005.02175.x.
To provide a description of the service delivery model of an assertive community treatment (ACT) team in the management of a group of severely mentally ill patients and examine the effectiveness of this team in reducing readmissions to a psychiatric inpatient service.
A clinical case audit was performed on a single day in September 2001. Admission episodes and duration were collected for patients registered with the team in the 12 month period prior to ACT and for a period of 12 months ending on the day of the audit. Forty-three patients were registered with the team at the time of data collection. The majority (79%) were diagnosed with schizophrenia and there were high rates of comorbidity (76%) and disability (mean Global Assessment of Functioning score 45.9). The main outcome measures were the number of readmissions and readmission days before and after the institution of ACT.
The mean number of readmission days reduced from 70.9 to 10.2 (p<0.05) following the institution of ACT.
Assertive community treatment conducted in a naturalistic clinical environment is effective in significantly reducing the number of readmission days in a group of patients suffering from long-term and persistent severe mental illness.
描述积极社区治疗（ACT）团队在管理一组重症精神病患者中的服务提供模式，并检验该团队在减少精神科住院再入院率方面的有效性。
于2001年9月的某一天进行了一项临床病例审核。收集了ACT实施前12个月内在该团队登记的患者以及截至审核当天的12个月期间的入院次数和住院时长。在数据收集时，该团队登记有43名患者。大多数患者（79%）被诊断为精神分裂症，共病率（76%）和残疾率较高（功能总体评定平均得分45.9）。主要结局指标为ACT实施前后的再入院次数和再入院天数。
ACT实施后，再入院天数的均值从70.9天降至10.2天（p<0.05）。
在自然主义临床环境中开展的积极社区治疗能有效显著减少一组患有长期持续性重症精神疾病患者的再入院天数。
