Hansson L
Department of Psychiatry, University Hospital, Lund, Sweden.
Acta Psychiatr Scand. 1989 Jun;79(6):571-8. doi: 10.1111/j.1600-0447.1989.tb10305.x.
Utilization of inpatient care in a catchment area was studied by means of a 4-year comparison before and after a sectorization of the care organization. There was almost no reduction in the number of patients hospitalized, but the number of admissions was reduced by 20% and the total number of days in hospital by 40%. An initial rise in the hospitalization of nonpsychotic patients was found in the new organization, probably because of the increased accessibility and availability of psychiatric care in the catchment area. The rate of hospitalization decreased for schizophrenic patients and remained unchanged for other psychotic patients. There was a significant reduction in rates of readmission, and mean length of stay in hospital was reduced for all groups of patients except patients with a diagnosis of neurosis or personality disorder. A reduction in rates of compulsory care, primarily for patients with alcohol diagnosis, was found. The sectorized care organization has fulfilled the objective of reducing inpatient care. However, great attention must be paid to evaluating new patient categories reached by the development of outpatient facilities, especially in areas where accessibility to and availability of the care organization were formerly low.
通过对医疗组织进行部门化前后四年的比较，研究了一个集水区内住院护理的使用情况。住院患者数量几乎没有减少，但入院次数减少了20%，住院总天数减少了40%。在新的组织中，发现非精神病患者的住院率最初有所上升，这可能是因为集水区内精神科护理的可及性和可得性增加了。精神分裂症患者的住院率下降，其他精神病患者的住院率保持不变。再入院率显著降低，除诊断为神经症或人格障碍的患者外，所有患者组的平均住院时间均缩短。发现强制护理率有所降低，主要是针对酒精诊断患者。部门化的医疗组织实现了减少住院护理的目标。然而，必须高度重视评估门诊设施发展所覆盖的新患者类别，特别是在医疗组织的可及性和可得性以前较低的地区。
