Janse van Rensburg A B
Division of Psychiatry, University of the Witwatersrand, Johannesburg, South Africa.
Afr J Psychiatry (Johannesbg). 2010 Nov;13(5):382-9. doi: 10.4314/ajpsy.v13i5.63104.
This is the first of three reports on a follow-up review of mental health care at Helen Joseph Hospital (HJH). In this first part, qualitative and quantitative descriptions were made of the services and of demographic and clinical data on acute mental health care users managed at HJH, in a retrospective review of clinical records over a four year period. Objectives for this review were to provide information on mental health care outcome, to do a cost analysis and to establish a quality assurance cycle that may facilitate a cost centre management approach. The operational areas identified were service delivery, teaching, and research. Activities within each area were in-patient care, out-patients and consultation/liaison, under- and postgraduate teaching and self initiated or contract research.
The study reviewed the existing mental health care program and activities in context of relevant policy and legislation.
Norms from a World Health Organization model for acute mental health care showed that significant staff shortages existed, especially for nursing. A total of 520 users were admitted for in-patient mental health care during the financial year 2007/08. The average length of stay was 15.4 days and ranged from 1 to 85 days. Ninety users (17%) had an extended period of stay of 25 days and more, while 39 users had multiple admissions during the 12 month period. The most common Axis I diagnoses made were schizophrenia n=138 (29%), substance-related conditions n=99 (21%) and bipolar mood disorder n=69 (14%). After discharge, 139 users (27%) were referred back to the HJH out-patient department for follow-up.
The information from these reports may be used in the allocation of adequate resources to align this acute unit with its responsibilities according to recent legislation.
这是关于海伦·约瑟夫医院（HJH）心理健康护理随访审查的三篇报告中的第一篇。在这第一部分中，通过对四年期间临床记录的回顾性审查，对HJH管理的急性心理健康护理服务以及使用者的人口统计学和临床数据进行了定性和定量描述。此次审查的目的是提供心理健康护理结果信息、进行成本分析并建立一个质量保证周期，以促进成本中心管理方法。确定的运营领域包括服务提供、教学和研究。每个领域的活动包括住院护理、门诊和咨询/联络、本科及研究生教学以及自主开展或合同研究。
该研究在相关政策和立法背景下审查了现有的心理健康护理项目和活动。
世界卫生组织急性心理健康护理模式的规范表明，存在严重的人员短缺，尤其是护理人员。在2007/08财政年度，共有520名使用者因心理健康问题住院。平均住院时间为15.4天，范围从1天到85天。90名使用者（17%）住院时间延长至25天及以上，39名使用者在12个月内多次入院。最常见的轴I诊断为精神分裂症（n = 138，29%）、物质相关疾病（n = 99，21%）和双相情感障碍（n = 69，14%）。出院后，139名使用者（27%）被转回HJH门诊部进行随访。
这些报告中的信息可用于分配足够的资源，以使这个急性护理单元根据近期立法履行其职责。
