Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry Zurich, Zurich, Switzerland.
Psychiatrie Baselland, Liestal, Switzerland.
Community Ment Health J. 2021 Jul;57(5):828-835. doi: 10.1007/s10597-020-00618-3. Epub 2020 Apr 11.
Home treatment (HT) has been proposed as an alternative to inpatient treatment for individuals in acute mental crises. However, there is limited evidence concerning the effectiveness of HT to date. The aim of this study was to investigate which patients benefit most from HT. The concept and utilization of two HT services in Switzerland were retrospectively compared based on routine medical data of all patients who were treated in one of the two HT services between July 2016 and December 2017. We examined which patient characteristics were related to successful replacement of hospital care by HT based on a calculated success score using binary regression analyses. The whole sample included 408 individuals with an average age of 43 years and of whom 68% were female. As a result of conceptual similarities, in both HT settings, the typical patient was middle-aged, female and having an affective disorder as the main diagnosis. Half of the treatment cases met the criteria of successful replacement of hospital care (> 50% of the total treatment episodes in HT, treatment duration < 40 days and treatment terminated by mutual agreement). The results of the regression analyses indicated that patients with a lower symptom severity at admission (lower HoNOS score) and those who were employed had more likely a successful replacement of hospital care.The findings suggest that patients with acute mental disorders who have a certain level of functioning and social support might benefit most from HT in the sense of successful replacement of hospital care.
家庭治疗(HT)已被提议作为急性精神危机患者住院治疗的替代方法。然而,迄今为止,关于 HT 的有效性的证据有限。本研究旨在调查哪些患者最受益于 HT。根据 2016 年 7 月至 2017 年 12 月期间在这两个 HT 服务中的一个接受治疗的所有患者的常规医疗数据,回顾性比较了瑞士两个 HT 服务的概念和使用情况。我们使用二元回归分析计算成功评分,研究了哪些患者特征与 HT 成功替代医院护理相关。整个样本包括 408 名平均年龄为 43 岁的个体,其中 68%为女性。由于概念上的相似性,在这两种 HT 环境中,典型患者为中年、女性,主要诊断为情感障碍。半数治疗病例符合成功替代医院护理的标准(HT 中总治疗例数的>50%、治疗持续时间<40 天且治疗经双方同意终止)。回归分析的结果表明,入院时症状严重程度较低(HoNOS 评分较低)和有工作的患者更有可能成功替代医院护理。研究结果表明,具有一定功能和社会支持的急性精神障碍患者可能最受益于 HT,从而成功替代医院护理。
Community Ment Health J. 2021-7
Community Ment Health J. 2022-2
Br J Psychiatry. 2020-6
Community Ment Health J. 2024-10
Int J Public Health. 2025-7-14
BMC Psychiatry. 2025-7-17
JAMA Netw Open. 2025-5-1
BMC Health Serv Res. 2025-3-18
Community Ment Health J. 2024-10
Int J Ment Health Syst. 2024-1-3
Br J Psychiatry. 1998-1