PSICOST Research Association,Departamento de Psicología,Universidad Loyola Andalucía,Sevilla,Spain.
Centre for Mental Health Research,Research School of Population Health College of Medicine,Biology and Environment,Australian National University,Research School of Population Health,63 Eggleston Road,Acton,ACT 2501,Australia.
Epidemiol Psychiatr Sci. 2019 Apr;28(2):210-223. doi: 10.1017/S2045796017000415. Epub 2017 Sep 18.
AIMS: There is a need of more quantitative standardised data to compare local Mental Health Systems (MHSs) across international jurisdictions. Problems related to terminological variability and commensurability in the evaluation of services hamper like-with-like comparisons and hinder the development of work in this area. This study was aimed to provide standard assessment and comparison of MHS in selected local areas in Europe, contributing to a better understanding of MHS and related allocation of resources at local level and to lessen the scarcity in standard service comparison in Europe. This study is part of the Seventh Framework programme REFINEMENT (Research on Financing Systems' Effect on the Quality of Mental Health Care in Europe) project. METHODS: A total of eight study areas from European countries with different systems of care (Austria, England, Finland, France, Italy, Norway, Romania, Spain) were analysed using a standard open-access classification system (Description and Evaluation of Services for Long Term Care in Europe, DESDE-LTC). All publicly funded services universally accessible to adults (≥18 years) with a psychiatric disorder were coded. Care availability, diversity and capacity were compared across these eight local MHS. RESULTS: The comparison of MHS revealed more community-oriented delivery systems in the areas of England (Hampshire) and Southern European countries (Verona - Italy and Girona - Spain). Community-oriented systems with a higher proportion of hospital care were identified in Austria (Industrieviertel) and Scandinavian countries (Sør-Trøndelag in Norway and Helsinki-Uusimaa in Finland), while Loiret (France) was considered as a predominantly hospital-based system. The MHS in Suceava (Romania) was still in transition to community care. CONCLUSIONS: There is a significant variation in care availability and capacity across MHS of local areas in Europe. This information is relevant for understanding the process of implementation of community-oriented mental health care in local areas. Standard comparison of care provision in local areas is important for context analysis and policy planning.
目的：需要更多定量的标准化数据来比较国际司法管辖区的本地精神卫生系统 (MHS)。在评估服务时，与术语可变性和可衡量性相关的问题阻碍了类似的比较，并阻碍了该领域的工作发展。本研究旨在为选定的欧洲本地地区的 MHS 提供标准评估和比较，有助于更好地了解 MHS 及其在本地层面的相关资源分配，并减少欧洲标准服务比较的稀缺性。本研究是第七框架计划 REFINEMENT（研究融资系统对欧洲精神卫生保健质量的影响）项目的一部分。
方法：使用标准的开放访问分类系统（欧洲长期护理服务描述和评估，DESDE-LTC）分析了来自具有不同护理系统的欧洲国家的总共 8 个研究区域（奥地利、英格兰、芬兰、法国、意大利、挪威、罗马尼亚、西班牙）。所有公开资助的服务均对成年（≥18 岁）有精神障碍的人普遍开放。对这八个本地 MHS 的护理可用性、多样性和能力进行了比较。
结果：MHS 的比较显示，英格兰（汉普郡）和南欧国家（意大利的维罗纳和西班牙的赫罗纳）的精神卫生系统更注重社区。在奥地利（Industrieviertel）和斯堪的纳维亚国家（挪威的 Sør-Trøndelag 和芬兰的赫尔辛基-乌西玛），发现了以社区为导向的系统，其中医院护理的比例更高，而 Loiret（法国）被认为是主要基于医院的系统。苏恰瓦（罗马尼亚）的 MHS 仍处于向社区护理过渡的阶段。
结论：欧洲本地地区的 MHS 在护理可用性和能力方面存在显著差异。这些信息对于了解社区为导向的精神卫生护理在本地地区的实施过程具有重要意义。本地地区护理提供的标准比较对于背景分析和政策规划很重要。
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