Ramperti Nicolas, Golden Daniel De La Harpe, Chinedu Iro, O'Casaide Seathrun, Kelly Frank
Ballyfermot Primary Care and Mental Health Centre, Ballyfermot, Dublin 10.
Dept of Psychiatry, St Luke's Hospital, Freshford Road, Kilkenny.
Ir J Psychol Med. 2012 Jan;29(3):190-193. doi: 10.1017/S0790966700017249.
To determine if a consultation/liaison mental health clinic in primary care as proposed for Vision for Change, The Primary Care Strategy and the Department of Health is an efficient model of delivering mental health care in Ireland.
The pattern of service use and the clinical characteristics of new patients attending a pilot consultation/liaison clinic in a local primary care centre were studied.
During the first 16 months of this clinic 1.2% of patients did not attend the initial assessment in the liaison clinic versus 29.75% in the regular Outpatients Department (OPD). Less than one in five (17.1%) required a follow-up review with the clinician in the consultation/liaison clinic compared to almost all patients first seen in OPD secondary care (96.6%). A small minority of patients (6.1%) needed referral to secondary care due to the complexity of their presentation.
A consultation/liaison mental health clinic in primary care results in an efficient use of manpower resources due to the low Did Not Attend (DNA) rates and low proportion of formal referrals to secondary care. As patients seem to favour this type of setting, over traditional outpatient departments, a move towards consultation/liaison clinics in the primary care team should be considered.
为确定《变革愿景》《初级保健战略》和卫生部所提议的初级保健中的会诊/联络精神卫生诊所是否是爱尔兰提供精神卫生保健的有效模式。
对当地一家初级保健中心试点会诊/联络诊所的新患者的服务使用模式和临床特征进行了研究。
在该诊所的前16个月中，1.2%的患者未参加联络诊所的初次评估，而在普通门诊部（OPD）这一比例为29.75%。在会诊/联络诊所中，不到五分之一（17.1%）的患者需要与临床医生进行随访复查，而在OPD二级保健中首次就诊的几乎所有患者（96.6%）都需要。由于病情复杂，一小部分患者（6.1%）需要转诊至二级保健。
由于低爽约率（未就诊率）和低比例的正式转诊至二级保健，初级保健中的会诊/联络精神卫生诊所能有效利用人力资源。由于患者似乎比传统门诊部更青睐这种类型的机构，应考虑在初级保健团队中向会诊/联络诊所转变。
