Nelson R P, Crocker A C
N Engl J Med. 1978 Nov 9;299(19):1039-44. doi: 10.1056/NEJM197811092991904.
Large public residential facilities have traditionally been society's primary service resource for persons with serious mental retardation. Despite current emphasis on restricting admissions and community placement of retarded persons, approximately 175,000 people continue to reside in 230 institutions throughout the United States. This population is vulnerable to a variety of chronic medical disorders that diminish successful adaptation to a more normal life-style, especially when health services are marginal. Institutional medical staffs have been largely isolated from their physician peers, and their patients have not had access to medical care equivalent to that available in the community. We describe the recent affiliation of a teaching hospital with a Massachusetts institution. We suggest that such affiliations would assure better medical care for mentally retarded persons while increasing physicians' knowledge of attendant medical and societal problems.
大型公共住宅设施传统上一直是社会为重度智力迟钝者提供的主要服务资源。尽管目前强调限制智力迟钝者的入院治疗和社区安置，但在美国各地的230家机构中，仍有约17.5万人居住在那里。这一群体易患各种慢性疾病，这些疾病会降低他们成功适应更正常生活方式的能力，尤其是在医疗服务有限的情况下。机构医护人员在很大程度上与同行医生隔绝，他们的患者无法获得与社区相当的医疗服务。我们描述了一家教学医院与马萨诸塞州一家机构最近的合作关系。我们认为，这种合作关系将确保为智力迟钝者提供更好的医疗服务，同时增加医生对相关医疗和社会问题的了解。
