Bonsack Charles, Wick Decrey Hedi, Conus Philippe
Rev Med Suisse. 2014 Sep 17;10(442):1715-8.
The burden of disease linked to mental disorders represents more than one-fifth of years lived with disability in the world. Less than half of people suffering from mental disorders are adequately treated. Three quarter of those who receive treatment are followed by primary care. Collaborative care aims to increase the efficiency of direct general practitioner's treatment. Main components are sustainable and individualized consultation-liaison relationship (1/2 day of psychiatrist by 15 days for 10-15 general practitioners), and support of a clinical case manager for complex situations. Collaboration is bidirectional: early or crisis access to specialist care and long-term followup by general practitioner. This model is a challenge for the doctor-patient dual relationship and requires incentives in a public health perspective.
与精神障碍相关的疾病负担占全球残疾生存年数的五分之一以上。患有精神障碍的人中，接受充分治疗的不到一半。接受治疗的人中有四分之三由初级保健机构跟进。协作护理旨在提高全科医生直接治疗的效率。主要组成部分包括可持续且个性化的咨询联络关系（10 - 15名全科医生每15天由一名精神科医生提供半天服务），以及为复杂情况配备临床病例管理员提供支持。协作是双向的：早期或危机情况下可获得专科护理，由全科医生进行长期随访。这种模式对医患二元关系构成挑战，从公共卫生角度来看需要激励措施。
