Schmidt L J, Reinhardt A M, Kane R L, Olsen D M
Arch Gen Psychiatry. 1977 Jun;34(6):687-91. doi: 10.1001/archpsyc.1977.01770180073006.
The reduction in state hospital populations in the last two decades is most often attributed to psychotropic medication and community mental health centers. The role the proprietary nursing home has played in this reduction has not been adequately studied. Using data routinely collected for Medicaid utilization review, we studied characteristics of psychiatric nursing home patients in Utah. One third of the nursing home patients had a psychiatric diagnosis; more than half of this group were classified as psychotic. Most psychotic patients were significantly younger than their nonpsychiatric counterparts. Nonpsychiatric patients received a higher mean number of psychoactive drugs than did psychiatric or mentally retarded patients. Over time, all groups of patients showed an increase in prescribed psychoactive medication and a decrease in activity. The consequence of this pattern of care raise serious questions about our current reliance on nursing homes for the care of the psychiatric patient.
过去二十年间州立医院住院人数的减少，通常被归因于精神药物和社区心理健康中心。私立疗养院在这一减少过程中所起的作用尚未得到充分研究。利用为医疗补助利用审查而常规收集的数据，我们研究了犹他州精神病疗养院患者的特征。三分之一的疗养院患者有精神疾病诊断；这一群体中超过一半被归类为精神病患者。大多数精神病患者比非精神病患者明显年轻。非精神病患者接受的精神活性药物平均数量高于精神病患者或智力迟钝患者。随着时间的推移，所有患者群体的处方精神活性药物都有所增加，而活动则有所减少。这种护理模式的后果引发了关于我们目前依赖疗养院护理精神病患者的严重问题。
