Burns T, Beadsmoore A, Bhat A V, Oliver A, Mathers C
St George's Hospital Medical School, London.
Br J Psychiatry. 1993 Jul;163:49-54. doi: 10.1192/bjp.163.1.49.
While research has shown community-based psychiatric care to be as good as, or better than, hospital-based care, generalisation to clinical practice has been difficult. This prospective, randomised controlled study examined a community-based approach feasible within NHS conditions. Ninety-four patients were randomly allocated to experimental and 78 to control treatments and followed for one year. The groups were well matched apart from an excess of psychotic control patients. No differences in clinical or social functioning outcome were found. Both groups improved substantially on clinical measures in the first six weeks, with some slow consolidation thereafter. There were three suicides in the control group and one in the experimental group. Access to care was better in the experimental group (93% attended assessment) than in the control group (75% attended assessment).
虽然研究表明，基于社区的精神科护理与基于医院的护理一样好，甚至更好，但要将其推广到临床实践却很困难。这项前瞻性随机对照研究检验了一种在英国国家医疗服务体系（NHS）条件下可行的基于社区的方法。94名患者被随机分配到试验组，78名患者被分配到对照组，并随访一年。除了对照组中精神疾病患者过多外，两组匹配良好。未发现临床或社会功能结局存在差异。两组在最初六周的临床指标上都有显著改善，此后改善速度有所放缓。对照组有3例自杀，试验组有1例自杀。试验组的护理可及性（93%的患者参加了评估）优于对照组（75%的患者参加了评估）。
