Redlich F, Kellert S R
Am J Psychiatry. 1978 Jan;135(1):22-8. doi: 10.1176/ajp.135.1.22.
Using the data collected by Hollingshead and Redlich in 1950 and their own recent data, the authors describe trends in the mental health field over a 25-year period. They found a marked increase in admissions and readmissions to inpatient facilities and a significant decrease in the average length of stay; a considerable increase in outpatient treatment services; a shift in major diagnostic categories from schizophrenia to alcoholism; an unequal allocation of services to young versus elderly patients; discharge of many chronic patients to nursing homes; the increased involvement of psychiatrists in administrative work and decreased time spent in direct patient care; and an increase in third-party insurance as a source of patient fees.
作者利用霍林斯黑德和雷德利希1950年收集的数据以及他们自己近期的数据，描述了25年间心理健康领域的发展趋势。他们发现，住院设施的入院和再入院人数显著增加，平均住院时间大幅缩短；门诊治疗服务大幅增加；主要诊断类别从精神分裂症转向酗酒；针对年轻患者和老年患者的服务分配不均；许多慢性病患者被送往疗养院；精神科医生参与行政工作的时间增加，直接护理患者的时间减少；第三方保险作为患者费用来源的比例增加。
