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精神科急症护理与“越多越少”悖论。

Psychiatric Crisis Care and the More is Less Paradox.

机构信息

Westat, IPS Employment Center, 85 Mechanic Street, Lebanon, NH, 03766, USA.

出版信息

Community Ment Health J. 2021 Oct;57(7):1230-1236. doi: 10.1007/s10597-021-00829-2. Epub 2021 May 15.

Abstract

Psychiatric crisis care in the U.S. exemplifies the "more is less paradox" of U.S. health care. We spend more for health care than any other high-income country, yet our outcomes are typically poor compared to these other countries (OECD in OECD health statistics. Retrieved from https://www.oced.org/health/health-data.html , 2020). We do this, in part, by emphasizing medical treatments for problems that are inherently social, rather than addressing social determinants of health. Medical interventions for socio-economic problems are usually expensive and ineffective. For mental health crisis care, adding unfunded, untested, medical interventions to the current mélange of poorly funded, disorganized arrangements will not help. Instead, the U.S. should address social determinants, emphasize research-based interventions, and emphasize prevention-proven strategies that decrease costs and improve outcomes.

摘要

美国的精神科危机护理体现了美国医疗保健的“多即是少悖论”。我们在医疗保健上的支出比任何其他高收入国家都多,但与这些国家相比,我们的结果通常较差(经合组织在经合组织卫生统计中。从 https://www.oced.org/health/health-data.html 中检索到,2020 年)。我们这样做的部分原因是强调对固有社会问题的医疗治疗,而不是解决健康的社会决定因素。针对社会经济问题的医疗干预通常既昂贵又无效。对于精神科危机护理,在当前资金不足、组织混乱的安排中增加未经资金支持和未经测试的医疗干预措施不会有帮助。相反,美国应该解决社会决定因素,强调基于研究的干预措施,并强调经过验证的预防策略,以降低成本并改善结果。

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