Kramer B A
Department of Psychiatry and the Behavioral Sciences, University of Southern California School of Medicine, Los Angeles.
Psychiatr Q. 1990 Summer;61(2):97-103. doi: 10.1007/BF01064910.
Availability of ECT in the United States often has been greater in the private sector than in the public sector. This is especially true in California, where ECT is heavily regulated. In 1986, ECT was available at 29.6% of the public hospitals and 42.9% of the private hospitals with psychiatric units in California. Public hospital patients accounted for 8.5% of all ECT in the state, while private hospital patients accounted for 91.5%. Of the 88 patients unable to give informed consent, 34.1% came from public hospitals vs. 65.9% from private hospitals. Two university-affiliated county hospitals accounted for 43 of 52 patients (82.7%) treated in the 6 county hospitals with psychiatric units. White patients accounted for 92.4% of ECT, leaving minorities undertreated. Private patients have a greater degree of choice regarding changing physician or hospital if ECT is needed but unavailable. The choices for public patients are limited. Possible causes and potential solutions to this problem are discussed.
在美国，电休克疗法（ECT）在私营部门的可及性通常高于公共部门。在加利福尼亚州尤其如此，该州对ECT实施严格监管。1986年，加利福尼亚州设有精神科病房的公立医院中，29.6%提供ECT，私立医院中这一比例为42.9%。该州公立医院的患者占所有ECT治疗患者的8.5%，而私立医院患者占91.5%。在88名无法给出知情同意的患者中，34.1%来自公立医院，65.9%来自私立医院。在设有精神科病房的6家县级医院中，两家大学附属医院接收了52名接受ECT治疗患者中的43名（82.7%）。接受ECT治疗的患者中白人占92.4%，少数族裔治疗不足。如果需要ECT但无法获得，私立患者在更换医生或医院方面有更大的选择度。公立患者的选择有限。本文讨论了该问题可能的原因及潜在解决方案。
