Franklin J L, Solovitz B, Mason M, Clemons J R, Miller G E
Am J Public Health. 1987 Jun;77(6):674-8. doi: 10.2105/ajph.77.6.674.
This project explores the efficiency and effectiveness of case management as compared with the usual and customary services available to chronic mentally ill individuals in reducing readmissions to mental hospitals and improving the quality of life. A randomized pretest-posttest control group design was used to assign 417 individuals who had at least two discharges from a mental hospital to an experimental (E) group (N = 213) to receive case management services and a control (C) group (N = 204) who could receive any services but case management. After participation in the project for 12 months, 138 members of the E group and 126 members of the C group were reinterviewed. The E group received more services, cost more to maintain, and were admitted to mental hospitals more often, but concomitant improvement in quality of life indicators was not evident. Alternative explanations for the findings are discussed.
本项目探讨了病例管理与慢性精神病患者可获得的常规服务相比，在减少再次入住精神病院及改善生活质量方面的效率和效果。采用随机前测-后测对照组设计，将至少有两次从精神病院出院记录的417名个体分配到实验组（E组，N = 213）接受病例管理服务，以及对照组（C组，N = 204），后者可接受除病例管理之外的任何服务。在参与项目12个月后，对E组的138名成员和C组的126名成员进行了再次访谈。E组接受了更多服务，维持成本更高，且更频繁地入住精神病院，但生活质量指标并未随之出现明显改善。文中讨论了这些研究结果的其他解释。
