Goldstein J M, Horgan C M
Bigel Institute for Health Policy, Florence Heller Graduate School, Brandeis University, Waltham, Massachusetts 02254.
Hosp Community Psychiatry. 1988 Jun;39(6):632-6. doi: 10.1176/ps.39.6.632.
Patients at risk for psychiatric hospitalization make only limited use of outpatient services, although clinical research has demonstrated that outpatient treatments and home care can be as effective as inpatient psychiatric treatment in treating certain mental health problems. The substitution of ambulatory services for inpatient care has in part been limited because insurers have restricted outpatient mental health benefits to control utilization. The authors critically review evidence from the economic and clinical literatures to determine the extent to which outpatient psychiatric treatment substitutes or complements inpatient treatment. To encourage clinically effective substitution of outpatient for inpatient services, further research is needed to identify the patient populations for whom substitution is possible and the treatment and environmental conditions in which it is most likely to be successful.
有精神科住院风险的患者对门诊服务的利用非常有限，尽管临床研究表明，在治疗某些心理健康问题方面，门诊治疗和家庭护理与住院精神科治疗一样有效。用门诊服务替代住院护理在一定程度上受到限制，因为保险公司限制了门诊心理健康福利以控制使用。作者批判性地回顾了经济和临床文献中的证据，以确定门诊精神科治疗替代或补充住院治疗的程度。为了鼓励临床上有效地用门诊服务替代住院服务，需要进一步研究以确定哪些患者群体可以进行替代，以及最有可能成功的治疗和环境条件。
