Quinlivan R, Hough R, Crowell A, Beach C, Hofstetter R, Kenworthy K
Mental health case management services, San Diego County Mental Health Services, California 92110, USA.
Psychiatr Serv. 1995 Apr;46(4):365-71. doi: 10.1176/ps.46.4.365.
The study evaluated the effects of an intensive case management model on clients' use of inpatient and outpatient psychiatric care and on the costs of care.
Ninety clients of a county mental health system who were frequent users of inpatient services were randomly assigned to either an intensive case management group, a traditional case management group, or a control group who received no particular services. Outcome variables measured over a two-year period were number of units used by clients and costs of inpatient care in county and private facilities and various types of outpatient care, including day treatment and use of an emergency psychiatric unit.
Clients who received intensive case management had fewer inpatient days and reduced overall costs for mental health services.
Assertive outreach and intensive case management can reduce hospitalizations of clients who are frequent users of inpatient care and can reduce overall mental health care costs. Mental health consumers employed as case management aides can play an important role in the delivery of mental health services, particularly with frequent users of inpatient care.
本研究评估了强化个案管理模式对客户住院和门诊精神科护理使用情况以及护理成本的影响。
某县心理健康系统中90名频繁使用住院服务的客户被随机分配到强化个案管理组、传统个案管理组或未接受特殊服务的对照组。在两年期间测量的结果变量包括客户使用的单位数量以及县立和私立机构的住院护理成本以及各类门诊护理成本，包括日间治疗和急诊精神科病房的使用情况。
接受强化个案管理的客户住院天数减少，心理健康服务的总体成本降低。
积极外展和强化个案管理可以减少频繁使用住院护理的客户的住院次数，并可以降低总体心理健康护理成本。受雇为个案管理助手的心理健康消费者在提供心理健康服务方面可以发挥重要作用，特别是对于频繁使用住院护理的客户。
