Feldman P S, Sadtler T M, Lipman R, Schiff L F
Hosp Community Psychiatry. 1979 May;30(5):334-7. doi: 10.1176/ps.30.5.334.
Two mental health catchment areas in Massachusetts that were in the process of phasing down state hospitals and building up community care provided an opportunity for studying the effectiveness of an integrated service delivery model and a nonintegrated model. The area that integrated state hospital and community services was more successful in the phase-down. It had a lower admission rate, the patients who were readmitted did not stay as long, and patients discharged spent more time in the community. Specific adminstrative and clinical structures that facilitated the patients' progress included investing community-based, administrative authority in one person; having a centralized intake and referral system; and using case managers to follow the clients through the service delivery system.
马萨诸塞州的两个精神卫生服务区域正在逐步减少州立医院规模并加强社区护理，这为研究综合服务提供模式和非综合服务提供模式的有效性提供了契机。整合了州立医院和社区服务的区域在逐步缩减规模方面更为成功。其住院率较低，再次入院的患者住院时间较短，出院患者在社区停留的时间更长。促进患者康复的具体行政和临床结构包括：将基于社区的行政权力集中于一人；建立集中的入院和转诊系统；以及使用个案管理员在整个服务提供系统中跟踪客户。
