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危机解决小组能否取代住院病房?一项法国准实验研究的结果。

Can a crisis resolution team replace an inpatient ward? Results from a French quasi-experimental study.

作者信息

Saez Laura, Ndjoh Eton Laken, Demessance Valérie, Rundstadler Amélie, Harquet Emilie, Lemetayer Fabienne, Soler Caroline

机构信息

EPSM Metz-Jury, Route d'Ars Laquenexy, 57245, Jury, France.

University of Lorraine, UFR SHS - Metz, Ile du Saulcy, Research Team 2LPN (EA7489), 57000, Metz, France.

出版信息

BMC Health Serv Res. 2025 Mar 18;25(1):404. doi: 10.1186/s12913-025-12396-3.


DOI:10.1186/s12913-025-12396-3
PMID:40102820
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11921558/
Abstract

BACKGROUND: Though promising, the implementation of crisis resolution teams has been unequal across Europe. In France, their deployment is currently receiving interest but there is to date no national policy and the research is scarce. METHODS: In the present study a psychiatric service converted one of its two inpatient wards into a crisis resolution team (EPSIAD) enabling a quasi-experimental naturalistic design. Variables on admissions, length of hospital stay and patient satisfaction were collected and analysed in the year preceding and the year following the conversion. RESULTS: In the year following the EPSIAD implementation, there were more admissions of female patients (41.0% vs 49.5%, p = 0.0262), a five-day decrease in the length of hospital stay (p < 0.0001) and increased patient satisfaction, with a particular increase in clarity of information, quality of the relationship with the care staff and service and feeling involved in medical decisions (p < 0.0001). CONCLUSIONS: The results of the present study indicate that the combination of a hospital ward with a crisis resolution team has the potential to increase global quality of care by providing a complementary mental health service. Crisis resolution teams may provide a viable alternative to hospitalisation that increases patient satisfaction and allows new patients to receive intensive care, with women especially benefiting from care at home. There is a need to cater for patients refusing psychiatric care altogether and hospital inpatient wards might specialise in involuntarily-admitted patient care.

摘要

背景:尽管危机解决团队很有前景,但在欧洲各地的实施情况并不均衡。在法国,其部署目前受到关注,但迄今为止尚无国家政策,相关研究也很匮乏。 方法:在本研究中,一家精神科服务机构将其两个住院病房之一改造成了一个危机解决团队(EPSIAD),从而实现了一种准实验性的自然主义设计。收集并分析了改造前一年和改造后一年的入院、住院时间和患者满意度等变量。 结果:在实施EPSIAD后的一年里,女性患者的入院人数增加(41.0%对49.5%,p = 0.0262),住院时间缩短了五天(p < 0.0001),患者满意度提高,特别是在信息清晰度、与医护人员及服务的关系质量以及参与医疗决策的感受方面有显著提高(p < 0.0001)。 结论:本研究结果表明,医院病房与危机解决团队相结合有可能通过提供补充性心理健康服务来提高整体护理质量。危机解决团队可能是一种可行的替代住院治疗的方式,可提高患者满意度,并使新患者能够接受强化护理,尤其是女性患者在家中接受护理受益更多。需要为完全拒绝精神科护理的患者提供服务,医院住院病房可能专门负责非自愿入院患者的护理。

相似文献

[1]
Can a crisis resolution team replace an inpatient ward? Results from a French quasi-experimental study.

BMC Health Serv Res. 2025-3-18

[2]
[Evaluation of a mobile crisis resolution team, better at home than in hospital?].

Soins Psychiatr. 2025

[3]
The CORE Service Improvement Programme for mental health crisis resolution teams: study protocol for a cluster-randomised controlled trial.

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[4]
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[5]
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Health Soc Care Deliv Res. 2023-12

[6]
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Soc Psychiatry Psychiatr Epidemiol. 2008-6

[7]
Handover of patient information from the crisis assessment and treatment team to the inpatient psychiatric unit.

Int J Ment Health Nurs. 2015-6

[8]
Protocol for a quasi-experimental study of the effectiveness and cost-effectiveness of mother and baby units compared with general psychiatric inpatient wards and crisis resolution team services (The ESMI study) in the provision of care for women in the postpartum period.

BMJ Open. 2019-3-23

[9]
Treating mental health crises at home: Patient satisfaction with home nursing care.

J Psychiatr Ment Health Nurs. 2020-6

[10]
[Can psychiatric acute teams reduce acute admissions to psychiatric wards?].

Tidsskr Nor Laegeforen. 2009-10-8

本文引用的文献

[1]
Effects of Patient-Initiated Brief Admissions on Psychiatric Care Consumption in Borderline Personality Disorder: ARegister-Based Study.

Int J Ment Health Nurs. 2024-12

[2]
Premature termination, satisfaction with care, and shared decision-making during home treatment compared to inpatient treatment: A quasi-experimental trial.

Eur Psychiatry. 2023-9-8

[3]
How to measure staff continuity in intensive psychiatric home treatment: a routine data and single case analysis.

Front Psychiatry. 2023-5-9

[4]
Equal access to outreach mental health care? Exploring how the place of residence influences the use of intensive home treatment in a rural catchment area in Germany.

BMC Psychiatry. 2022-12-26

[5]
The effectiveness of intensive home treatment as a substitute for hospital admission in acute psychiatric crisis resolution in the Netherlands: a two-centre Zelen double-consent randomised controlled trial.

Lancet Psychiatry. 2022-8

[6]
Effectiveness of crisis resolution home treatment for the management of acute psychiatric crises in Southern Switzerland: a natural experiment based on geography.

BMC Psychiatry. 2022-6-17

[7]
Accessibility and interventions of crisis resolution teams: a multicenter study of team practices and team differences in Norway.

BMC Psychiatry. 2022-5-21

[8]
A scoping review of studies into crisis resolution teams in community mental health services.

Nord J Psychiatry. 2022-11

[9]
Fidelity to an evidence-based model for crisis resolution teams: a cross-sectional multicentre study in Norway.

BMC Psychiatry. 2021-5-4

[10]
Implementation, efficacy, costs and processes of inpatient equivalent home-treatment in German mental health care (AKtiV): protocol of a mixed-method, participatory, quasi-experimental trial.

BMC Psychiatry. 2021-3-30

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