Semke J, Hanig D
School of Social Work, University of Washington, Seattle 98195, USA.
Psychiatr Serv. 1995 Mar;46(3):238-42. doi: 10.1176/ps.46.3.238.
Research on psychiatric hospital admissions shows that a small group of patients use a disproportionate amount of inpatient services. In the late 1980s Washington State developed initiatives to target outpatient community mental health services to mentally ill persons with high rates of inpatient psychiatric service use. Services to the targeted group are provided by regional support networks under contract with the state. Diverse funding sources were consolidated to give the regional authorities flexibility to tailor funding to local needs, and new appropriations were tied to the region's commitment to increase capacity for community mental health services. To support those initiatives, the state developed a specialized client-focused database to identify individuals with high rates of hospital utilization, provide information to regional authorities about use of hospital services by those individuals, and assess whether they were receiving outpatient services. Analyses of statewide data showed wide variation among regions in hospital use and delivery of community services.
对精神病医院住院情况的研究表明，一小部分患者占用了不成比例的住院服务量。20世纪80年代末，华盛顿州发起了一些举措，将门诊社区心理健康服务目标对准那些住院精神科服务使用率高的精神病患者。针对该目标群体的服务由与该州签订合同的区域支持网络提供。多种资金来源被整合起来，以便赋予区域当局根据当地需求调整资金的灵活性，并且新的拨款与该地区增加社区心理健康服务能力的承诺挂钩。为了支持这些举措，该州开发了一个专门的以客户为中心的数据库，以识别医院利用率高的个体，向区域当局提供有关这些个体使用医院服务的信息，并评估他们是否正在接受门诊服务。对全州数据的分析表明，各地区在医院使用情况和社区服务提供方面存在很大差异。
