Marcos L R, Gil R M, Vazquez K M
Hosp Community Psychiatry. 1986 Feb;37(2):171-4. doi: 10.1176/ps.37.2.171.
The authors assess the impact of a policy adopted briefly in New York State to facilitate short-term hospitalization and long-term aftercare of psychiatrically disturbed, developmentally disabled patients. Denied admission to New York State facilities that provide long-term care for the psychiatrically disturbed or the developmentally disabled, these dually diagnosed patients have often languished in the emergency room of municipal hospitals or been inappropriately hospitalized in the acute-care psychiatric unit, sometimes for several months. The authors conclude that the policy expedited hospitalization but failed to facilitate patients' discharge because it did not address the underlying need for suitable aftercare facilities. Overlapping clinical and administrative issues and political exigencies that complicated the policymaking process are discussed.
作者评估了纽约州一项短期实施的政策的影响，该政策旨在为患有精神疾病且有发育障碍的患者提供短期住院治疗和长期后续护理。这些双重诊断的患者被拒绝进入纽约州为精神疾病患者或发育障碍患者提供长期护理的机构，他们常常在市立医院的急诊室中受苦，或在急性护理精神科病房中接受不适当的住院治疗，有时长达数月。作者得出结论，该政策加快了住院速度，但未能促进患者出院，因为它没有解决对合适的后续护理设施的根本需求。文中还讨论了重叠的临床和行政问题以及使决策过程复杂化的政治紧急情况。
