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低收入和中等收入国家中长期身心健康状况患者的综合护理。

Integrated care for people with long-term mental and physical health conditions in low-income and middle-income countries.

作者信息

Thornicroft Graham, Ahuja Shalini, Barber Sarah, Chisholm Daniel, Collins Pamela Y, Docrat Sumaiyah, Fairall Lara, Lempp Heidi, Niaz Unaiza, Ngo Vicky, Patel Vikram, Petersen Inge, Prince Martin, Semrau Maya, Unützer Jürgen, Yueqin Huang, Zhang Shuo

机构信息

Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.

Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Public Health Foundation of India, New Delhi, India.

出版信息

Lancet Psychiatry. 2019 Feb;6(2):174-186. doi: 10.1016/S2215-0366(18)30298-0. Epub 2018 Nov 15.

Abstract

Integrated care is defined as health services that are managed and delivered such that people receive a continuum of health promotion, disease prevention, diagnosis, treatment, disease management, rehabilitation, and palliative care services, coordinated across the different levels and sites of care within and beyond the health sector and, according to their needs, throughout the life course. In this Review, we describe the most relevant concepts and models of integrated care for people with chronic (or recurring) mental illness and comorbid physical health conditions, provide a conceptual overview and a narrative review of the strength of the evidence base for these models in high-income countries and in low-income and middle-income countries, and identify opportunities to test the feasibility and effects of such integrated care models. We discuss the rationale for integrating care for people with mental disorders into chronic care; the models of integrated care; the evidence of the effects of integrating care in high-income countries and in low-income and middle-income countries; the key organisational challenges to implementing integrated chronic care in low-income and middle-income countries; and the practical steps to realising a vision of integrated care in the future.

摘要

整合照护被定义为一种健康服务,其管理与提供方式能让人们获得一系列连续的健康促进、疾病预防、诊断、治疗、疾病管理、康复及姑息治疗服务,这些服务在卫生部门内外的不同照护层级和场所间得到协调,并根据人们的需求贯穿其一生。在本综述中,我们描述了针对患有慢性(或复发性)精神疾病及合并躯体健康状况的人群的最相关整合照护概念和模式,对高收入国家以及低收入和中等收入国家中这些模式的证据基础强度进行概念性概述和叙述性综述,并确定检验此类整合照护模式可行性和效果的机会。我们讨论了将精神障碍患者的照护整合到慢性照护中的基本原理;整合照护模式;高收入国家以及低收入和中等收入国家中整合照护效果的证据;低收入和中等收入国家实施整合慢性照护的关键组织挑战;以及未来实现整合照护愿景的实际步骤。

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