Agyapong Vincent Io, Ahmodu Olorunfemi, Guerandel Allys
Dept of Psychiatry,School of Medicine,University of Dublin,Trinity College and St Patrick's University Hospital,James's Street,Dublin 8,Ireland.
St Vincent's University Hospital,Dublin 4,Ireland.
Ir J Psychol Med. 2011 Sep;28(3):138-140. doi: 10.1017/S0790966700012118.
Primary care teams have the potential to deliver much of the care currently provided by specialist services. The aim of this review was to determine from patients' clinical records and multidisciplinary team discussions, those that may be suitable for discharge back into primary care.
A retrospective review of the clinical notes of all patients attending a psychiatric outpatient clinic was carried out by all members of the multidisciplinary team to determine the appropriateness of continuing to provide psychiatric services in a specialised psychiatric clinic rather than in a primary care setting, taking into account the patients demographic and clinical variables.
It was recommended that 60% of all the patients needed to continue attending the local mental health service, 35.2% could be discharged back into primary care for continuing management whilst the remaining 4.8% could be managed jointly between primary care and the community mental health service. The bulk of the patients recommended for discharge into primary care had a diagnosis of anxiety disorder or depression and all of them had been stable on their treatment for more than six months.
Regular multidisciplinary team review has a potential to identify patients who could be discharged back into primary care.
基层医疗团队有潜力提供目前由专科服务提供的大部分护理。本综述的目的是从患者的临床记录和多学科团队讨论中确定那些可能适合转回基层医疗的患者。
多学科团队的所有成员对所有到精神科门诊就诊的患者的临床记录进行了回顾性审查，以确定在考虑患者的人口统计学和临床变量的情况下，继续在专科精神科诊所而非基层医疗机构提供精神科服务是否合适。
建议60%的患者需要继续到当地心理健康服务机构就诊，35.2%的患者可以转回基层医疗进行持续管理，其余4.8%的患者可以由基层医疗和社区心理健康服务机构联合管理。建议转回基层医疗的大部分患者被诊断为焦虑症或抑郁症，并且他们所有的治疗都已稳定超过六个月。
定期的多学科团队审查有可能识别出可以转回基层医疗的患者。
