Hallam A, Beecham J, Knapp M, Fenyo A
Personal Social Services Research Unit, University of Kent at Canterbury, UK.
Eur Arch Psychiatry Clin Neurosci. 1994;243(6):304-10. doi: 10.1007/BF02195724.
The development of community services to replace two long-stay psychiatric hospitals in the North East Thames Health Authority region of the UK has been the subject of a research programme since 1985. The economic evaluation is conducted by the Personal Social Services Research Unit; research results relating to the first five cohorts of hospital leavers are reported in this paper. When followed up 1 year after discharge, almost half of the sample were living in highly supported residential care units, most of which were managed by district health authorities. More than 40 services provided outside the accommodation facility were used by clients and, although contact with certain professionals remained constant, some changes in service use over time were marked. The average total cost of community care for this group was 493 pounds per week (1992-93 prices), accommodation facility costs comprising approximately 85% of the total. In the new service configuration, district health authorities fund half of the costs of supporting the hospital leavers, 50% less than when they funded long-stay hospital placements. The rest of the funding burden is borne by a range of agencies, resulting in pressure on budgets and staff case loads.
自1985年以来，英国东北泰晤士河卫生管理局地区为取代两家长期精神病院而开展社区服务发展项目，一直是一项研究计划的主题。经济评估由个人社会服务研究单位进行；本文报告了与首批五批出院患者相关的研究结果。出院1年后进行随访时，近一半的样本居住在得到高度支持的寄宿护理机构中，其中大部分由地区卫生管理局管理。客户使用了40多种住宿设施以外提供的服务，尽管与某些专业人员的联系保持不变，但随着时间的推移，服务使用情况出现了一些显著变化。该群体社区护理的平均总成本为每周493英镑（1992 - 93年价格），住宿设施成本约占总成本的85%。在新的服务配置中，地区卫生管理局为支持出院患者的费用提供一半资金，比他们为长期住院安排提供资金时少50%。其余的资金负担由一系列机构承担，这给预算和工作人员的工作量带来了压力。
