比较英格兰接受精神分裂症和严重非精神病治疗的成年和老年患者的服务利用情况和成本：对委托的影响。

Comparison of service utilisation and costs of working age adults and older adults receiving treatment for psychosis and severe non-psychotic conditions in England: implications for commissioning.

机构信息

Surrey and Borders Partnership NHS Foundation Trust, Surrey, UK.

Central North West London NHS Foundation Trust, London, UK.

出版信息

Int J Geriatr Psychiatry. 2017 Jan;32(1):110-115. doi: 10.1002/gps.4455. Epub 2016 Mar 10.

DOI:10.1002/gps.4455

PMID:26968429

Abstract

OBJECTIVE

Current plans in the English National Health Service are to replace block contracts for mental health providers with a single tariff for each 'cluster' of conditions. A single tariff will not take into account the potential additional complexity and costs inherent in caring for older people. To examine the basis for a uniform tariff, differences in service utilisation and costs between working age adults and older adults in two populous clusters (non-psychotic, psychotic) were investigated across five mental health healthcare providers in and around London.

METHODS

Retrospective review of records over 3 months assessing service utilisation and costs using the Client Services Receipt Inventory.

RESULTS

Records of 362 patients were reviewed, 179 older adults (90 non-psychotic, 89 psychotic) and 183 adults of working age (83 non-psychotic, 100 psychotic). Older adults in both clusters had more tests, assessments and home visits. Overall costs of care of older adults were significantly higher in the non-psychotic cluster (£5634, vs £4405 psychotic, p = 0.044).

CONCLUSIONS

摘要

目的

英国国家医疗服务体系目前的计划是用每种“集群”疾病的单一费率取代精神卫生服务提供商的区块合同。单一的费率将不会考虑到照顾老年人所固有的潜在额外复杂性和成本。为了研究统一费率的依据，在伦敦及周边地区的五家精神卫生保健机构中，对两个人口较多的集群（非精神病性、精神病性）中成年工作者和老年人之间的服务利用和成本差异进行了调查。

方法

使用客户服务收据清单对 3 个月的记录进行回顾性评估，以评估服务利用和成本。

结果

共审查了 362 名患者的记录，其中 179 名老年人（90 名非精神病性，89 名精神病性）和 183 名成年工作者（83 名非精神病性，100 名精神病性）。两个集群中的老年人接受了更多的检查、评估和家访。非精神病性集群中老年人的整体护理费用明显更高（5634 英镑，而精神病性为 4405 英镑，p=0.044）。