Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, U.S.A.
Neuropsychiatric Research Institute, Fargo, North Dakota, U.S.A.
Int J Eat Disord. 2018 Sep;51(9):1051-1055. doi: 10.1002/eat.22899. Epub 2018 Sep 6.
In the United States, the past decade has seen rapid growth in treatment centers providing specialty care to patients with eating disorders. Much of this growth has been in higher levels of care, including hospital-based and residential treatment. Despite this expansion, there remains lack of agreement regarding the most important components of care, such as staff training or specifics of treatment delivery. Additionally there is no consensus on how best to assess outcome and compare performance across programs. This leaves patients, families, public and private insurance programs, and policy makers with limited information to help facilitate treatment decisions. The present paper considers implications of these changes in the eating disorder treatment landscape and examines two ideas that, if implemented, may enhance the quality of eating disorder care. First, we explore the proposal to develop a network of centers of excellence in eating disorder treatment and the value this may have for improving overall treatment quality. This idea was discussed at an expert meeting held at SAMSHA in 2017 regarding issues important to the field following passage of the 21st Century Cures Act. Second, we consider the potential utility of a study using the Delphi method to promote expert consensus regarding clinical outcome assessments.
在美国，过去十年中，提供专门治疗饮食失调症患者的治疗中心迅速增加。这种增长主要集中在更高层次的护理上，包括基于医院的和住院治疗。尽管有了这种扩张，但对于护理中最重要的组成部分，如人员培训或治疗提供的具体细节，仍然没有达成共识。此外，对于如何最好地评估结果以及如何比较不同项目的绩效，也没有共识。这使得患者、家属、公共和私人保险计划以及政策制定者获得的信息有限，无法帮助他们做出治疗决策。本文考虑了饮食失调症治疗领域这些变化的影响，并探讨了两个想法，如果实施，可能会提高饮食失调症治疗的质量。首先，我们探讨了在饮食失调症治疗方面建立卓越中心网络的建议，以及这对提高整体治疗质量的价值。这个想法是在 2017 年 SAMSHA 举行的一次专家会议上讨论的，会议讨论了在 21 世纪治愈法案通过后对该领域很重要的问题。其次，我们考虑了使用德尔菲法进行研究的潜在效用，以促进专家就临床结果评估达成共识。
