School of Population Health, University of Queensland, Brisbane, Australia.
Aust N Z J Psychiatry. 2012 Oct;46(10):982-94. doi: 10.1177/0004867412452942. Epub 2012 Jul 16.
To derive planning estimates for the provision of public mental health services in Queensland 2007-2017.
We used a five-step approach that involved: (i) estimating the prevalence and severity of mental disorders in Queensland, and the number of people at each level of severity treated by health services; (ii) benchmarking the level and mix of specialised mental health services in Queensland against national data; (iii) examining 5-year trends in Queensland public sector mental health service utilisation; (iv) reviewing Australian and international planning benchmarks; and (v) setting resource targets based on the results of the preceding four steps. Best available evidence was used where possible, supplemented by value judgements as required.
Recommended resource targets for inpatient service were: 20 acute beds per 100,000 population, consistent with national average service provision but 13% above Queensland provision in 2005; and 10 non-acute beds per 100,000, 65% below Queensland levels in 2005. Growth in service provision was recommended for all other components. Adult residential rehabilitation service targets were 10 clinical 24-hour staffed beds per 100,000, and 18 non-clinical beds per 100,000. Supported accommodation targets were 35 beds per 100,000 in supervised hostels and 35 places per 100,000 in supported public housing. A direct care clinical workforce of 70 FTE per 100,000 for ambulatory care services was recommended. Fifteen per cent of total mental health funding was recommended for community support services provided by non-government organisations.
The recommended targets pointed to specific areas for priority in Queensland, notably the need for additional acute inpatient services for older persons and expansion of clinical ambulatory care, residential rehabilitation and supported accommodation services. The development of nationally agreed planning targets for public mental health services and the mental health community support sector were identified as priorities.
为昆士兰州 2007-2017 年提供公共精神卫生服务制定规划估算。
我们采用了五步方法，包括：（i）估计昆士兰州精神障碍的患病率和严重程度，以及每一级严重程度的患者接受卫生服务治疗的人数；（ii）根据国家数据对昆士兰州的专门精神卫生服务水平和组合进行基准测试；（iii）审查昆士兰州公共部门精神卫生服务利用 5 年的趋势；（iv）审查澳大利亚和国际规划基准；（v）根据前四个步骤的结果设定资源目标。尽可能使用现有最佳证据，并根据需要进行价值判断。
推荐的住院服务资源目标为：每 10 万人有 20 张急性病床，与全国平均服务水平一致，但比 2005 年昆士兰州的服务水平高 13%；每 10 万人有 10 张非急性病床，比 2005 年昆士兰州的水平低 65%。建议所有其他组件都增加服务提供。成人住院康复服务的目标为每 10 万人有 10 个临床 24 小时工作人员床位和 18 个非临床床位。支持性住宿的目标是每 10 万人有 35 个床位在监督宿舍和 35 个床位在支持性公共住房。建议为门诊服务配备 70 名 FTE 的直接护理临床工作人员。建议将 15%的精神卫生总资金用于非政府组织提供的社区支持服务。
建议的目标指出了昆士兰州的优先重点领域，特别是需要为老年人提供更多的急性住院服务，并扩大临床门诊服务、住院康复和支持性住宿服务。制定全国统一的公共精神卫生服务和精神卫生社区支持部门规划目标被确定为优先事项。
