一项关于心理健康领域过渡性医院服务的全国性研究。
A national study of transitional hospital services in mental health.
作者信息
Dorwart R A, Hoover C W
机构信息
Malcolm Wiener Center for Social Policy, John F. Kennedy School of Government, Harvard University, Cambridge, MA 02138.
出版信息
Am J Public Health. 1994 Aug;84(8):1229-34. doi: 10.2105/ajph.84.8.1229.
OBJECTIVES
Shifts in care for the seriously mentally ill from inpatient to community-based treatment have highlighted the importance of transitional care. Our objectives were to document the kinds and quantity of transitional services provided by psychiatric hospitals nationally and to assess the impact of hospital type (psychiatric vs general), ownership (public vs private), case mix, and revenue source on provision of these services.
METHODS
A national sample of nonfederal inpatient mental health facilities (n = 915) was surveyed in 1988, and data were analyzed by using multiple regression.
RESULTS
Half (46%) of the facilities surveyed provided patient follow-up of 1 week or less, and almost all (93%) conducted team review of discharge plans, but 74% provided no case management services. Hospital type was the most consistent predictor of transitional care, with psychiatric hospitals providing more of these services than general hospitals. Severity of illness, level of nonfederal funding, urbanicity, and teaching hospital affiliation were positively associated with provision of case management.
CONCLUSIONS
Transitional care services for mentally ill patients leaving the hospital were found to be uneven and often inadequate. Reasons for broad variation in services are discussed.
目标
严重精神疾病患者的护理模式从住院治疗向社区治疗的转变凸显了过渡性护理的重要性。我们的目标是记录全国精神病医院提供的过渡性服务的种类和数量，并评估医院类型（精神病医院与综合医院）、所有权（公立与私立）、病例组合以及收入来源对这些服务提供情况的影响。
方法
1988年对全国非联邦住院心理健康设施的一个样本（n = 915）进行了调查，并使用多元回归分析数据。
结果
接受调查的设施中有一半（46%）提供的患者随访时间为1周或更短，几乎所有设施（93%）都对出院计划进行了团队审查，但74%的设施未提供病例管理服务。医院类型是过渡性护理最一致的预测因素，精神病医院提供的此类服务比综合医院更多。疾病严重程度、非联邦资金水平、城市化程度以及教学医院附属关系与病例管理的提供呈正相关。
结论
发现为出院的精神病患者提供的过渡性护理服务参差不齐，且往往不足。讨论了服务存在广泛差异的原因。
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