Katz S E, Cancro R
Hosp Community Psychiatry. 1982 Sep;33(9):728-31. doi: 10.1176/ps.33.9.728.
From their beginnings, county or municipal psychiatric services have reflected the political and social attitudes of the times. Traditionally they were public facilities that delivered acute inpatient care and a variable range of outpatient services, and, within their mandate, they functioned well. During the past two decades institutional psychiatry has evolved in such a way that there is little difference in the range of services delivered by county, state, and voluntary facilities. The logical role of the county hospital continues to be the provision of acute care for the poor. But for county systems to survive and flourish, they must be prepared to regionalize some services, and to differentiate their role in relation to voluntary and state facilities, yet integrate services with them where needed. They must strengthen ties with academic institutions and effectively address problems of third-party payment and other financial issues.
从一开始，县或市的精神科服务就反映了当时的政治和社会态度。传统上，它们是提供急性住院护理和各种门诊服务的公共设施，并且在其职责范围内运作良好。在过去的二十年里，机构精神病学已经发展到县、州和志愿机构提供的服务范围几乎没有差异的程度。县医院的合理作用仍然是为穷人提供急性护理。但是，要使县系统生存和繁荣，它们必须准备好将一些服务区域化，明确它们与志愿机构和州机构相比的不同作用，同时在需要时与它们整合服务。它们必须加强与学术机构的联系，并有效解决第三方支付和其他财务问题。
