National Hospital Organization Higashiowari National Hospital, 2-1301, Omorikita, Moriyama-ku, Nagoya-shi, Aichi 463-0802, Japan.
Community Ment Health J. 2013 Aug;49(4):477-91. doi: 10.1007/s10597-012-9562-6. Epub 2012 Nov 29.
We applied an American medical necessity scale, Level of Care Utilization System for Psychiatric and Addiction Services (LOCUS), to psychiatric practice in Japan. This is an exploratory analysis of empirical data of 272 patients. We examined the relationships between levels of care of LOCUS and clinical variables, contribution of care levels on admission decision, and changes in care levels over time. Inpatients showed significantly higher levels of care than outpatients. Levels of care showed significant strong inverse correlations to Global Assessment Scale (GAS) scores, and significant moderate correlations to admission types, care environment, and diagnostic subgroups in almost all groups. Levels of care contributed as much to the admission decision as GAS scores. Levels of care significantly decreased from the time of admission to discharge. Our preliminary evidence indicates that LOCUS is valid and sensitive to change, and applicable for clinical use in Japan.
我们将美国医疗必要性量表——精神科和成瘾服务利用程度分级系统（LOCUS）应用于日本的精神科实践。这是对 272 名患者的实证数据进行的探索性分析。我们检验了 LOCUS 的护理级别与临床变量之间的关系、护理级别对入院决策的贡献，以及随时间推移护理级别变化的情况。住院患者的护理级别明显高于门诊患者。在几乎所有组中，LOCUS 的护理级别与总体评估量表（GAS）评分呈显著的强负相关，与入院类型、护理环境和诊断亚组呈显著的中度相关。护理级别对入院决策的贡献与 GAS 评分一样大。护理级别从入院到出院显著降低。我们的初步证据表明，LOCUS 是有效和敏感的变化，适用于日本的临床应用。
