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[德国精神科门诊的法定义务及其实际护理状况]

[Statutory duties of German psychiatric outpatient clinics and their real care conditions].

作者信息

Valdes-Stauber Juan, Kilian Reinhold

机构信息

Zentrum für Psychiatrie Südwürttemberg, Universität zu Ulm I.

出版信息

Psychiatr Prax. 2013 Apr;40(3):146-53. doi: 10.1055/s-0032-1327413. Epub 2013 Jan 23.

Abstract

OBJECTIVE

This study examines whether psychiatric outpatient clinics fulfill their statutory role of providing psychiatric services for patients with severe mental disorders.

METHODS

A retrospective cross-sectional study on 1,672 patients of a psychiatric outpatient clinic for the year 2010, based on 30 variables. Associations between variables were explored by means of robust multivariate regression models and polynomial regression plots.

RESULTS

The patients' average CGI value was found to be 5.98, the mean GAF-score 47.3, and the mean duration of illness 13.8 years. A third of the sample attempted suicide in the past. Metabolic comorbidity was found in 23.1 % of the sample. Results of regression analyses reveal positive effects of the disease severity and functional impairment on the use of psychiatric care. Patients with affective and schizophrenic disorders received more units of care and caused more costs. Patients living in nursing homes received less in- and outpatient care but caused more medication costs.

CONCLUSIONS

Study results support the assumption that German psychiatric outpatient clinics fulfill their statutory duties by treating severely chronically mentally ill patients. The patients' use of care is positively related to the disease severity and their functional impairment. However, results of the regression analyses suggest that patients living in nursing homes received less psychiatric care than patients who live more independently.

摘要

目的

本研究旨在探讨精神科门诊是否履行了为重度精神障碍患者提供精神科服务的法定职责。

方法

基于30个变量,对一家精神科门诊2010年的1672例患者进行回顾性横断面研究。通过稳健的多元回归模型和多项式回归图探索变量之间的关联。

结果

发现患者的平均临床总体印象量表(CGI)值为5.98,平均大体功能评定量表(GAF)得分47.3,平均病程13.8年。三分之一的样本过去曾尝试自杀。23.1%的样本存在代谢合并症。回归分析结果显示疾病严重程度和功能损害对精神科护理使用有积极影响。情感障碍和精神分裂症患者接受了更多的护理单元且费用更高。住在养老院的患者接受的门诊和住院护理较少,但药物费用更高。

结论

研究结果支持这样一种假设,即德国精神科门诊通过治疗重度慢性精神病患者履行了其法定职责。患者对护理的使用与疾病严重程度及其功能损害呈正相关。然而,回归分析结果表明,住在养老院的患者比生活更独立的患者接受的精神科护理更少。

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