Medel A, Sarria A
Agencia de Evaluación de Tecnologías Sanitarias, Instituto de Salud Carlos III, Sinesio Delgado, 4. Pabellón 4, 28029 Madrid, Spain.
Actas Esp Psiquiatr. 2009 Mar-Apr;37(2):82-93.
Comparative analysis by Spanish Regional Communities (RC) of indicators related to morbidity and staffing in psychiatric care hospital over a period of time (1980-2004) marked by the initiation and development of deinstitutionalization policies and handover of powers to RC.
Longitudinal study. Descriptive analysis of variables, broken down by RC, related to psychiatric morbidity (ICD-9, codes 290-319) and indicators of hospital staffing over a 25-year period. DATABASE SOURCE: Hospital Morbidity Survey, 1980-2004 and Statistics for care facilities providing in-patient care regime, 1980-2004.
Differences between Regional Communities are substantial in all the analyzed variables: discharges, total and average stay, total and initial consultations, rate of psychiatrists in hospital care, number of beds and psychiatric hospitals. For all the Regional Communities as a whole, an increase is observed in hospital discharges, decrease of total and mean stays, notable increase of consultations, little increase in psychiatric staff in hospital care and stagnation in the decline of psychiatric hospitals and beds in operation in psychiatric hospital during the last period of time series and low increase in beds for the hospitals that are not classified as a psychiatric hospital.
We found evidence of qualitatively different care models between Regional Communities and substantial changes in major indicators over time series.
西班牙各自治区(RC)对一段时期(1980 - 2004年)内精神病护理医院发病率和人员配备相关指标进行的比较分析,这段时期以去机构化政策的启动和发展以及权力移交给自治区为标志。
纵向研究。按自治区对与精神病发病率(国际疾病分类第九版,编码290 - 319)及25年期间医院人员配备指标相关的变量进行描述性分析。数据库来源:1980 - 2004年医院发病率调查以及1980 - 2004年提供住院护理制度的护理机构统计数据。
各自治区在所有分析变量上存在显著差异:出院人数、总住院天数和平均住院天数、总会诊次数和初诊次数、医院护理中的精神科医生比例、病床数量和精神病医院数量。就所有自治区整体而言,观察到医院出院人数增加、总住院天数和平均住院天数减少、会诊次数显著增加、医院护理中的精神科工作人员略有增加,在时间序列的最后阶段,运营中的精神病医院和病床数量下降停滞,非精神病医院的病床数量增幅较小。
我们发现各自治区之间存在质量上不同的护理模式,并且随着时间序列主要指标发生了重大变化。