Geller J L
University of Massachusetts Medical School, Worcester.
Hosp Community Psychiatry. 1993 Feb;44(2):141-6. doi: 10.1176/ps.44.2.141.
Treatments applicable to the frequently rehospitalized psychiatric patient--the so-called revolving-door patient--have been poorly delineated. One subgroup of these patients includes those for whom recidivism has become a way of life; they may be said to suffer from "hospitalphilia." Neither refractoriness to treatment nor noncompliance with medications explains their frequent admissions. The author presents ten clinical principles to guide treatment planning for this subgroup of patients. The principles emphasize cooperation between the patient and the treatment agencies in creating a comprehensive, consistent, and enforceable plan to reduce unnecessary hospitalizations. Four treatment strategies based on the principles are outlined: unlimited access to hospitalization, a chit or voucher system, a rationing system, and an approach centered on the patient's expressed ability to avoid hospitalization.
适用于频繁再次住院的精神科患者（即所谓的“旋转门”患者）的治疗方法尚未得到明确界定。这些患者中的一个亚组包括那些将复发视为一种生活方式的人；可以说他们患有“住院癖”。治疗抵抗或不遵医嘱用药都无法解释他们频繁住院的原因。作者提出了十条临床原则，以指导针对这一亚组患者的治疗计划制定。这些原则强调患者与治疗机构之间的合作，以制定一个全面、一致且可执行的计划，以减少不必要的住院治疗。文中概述了基于这些原则的四种治疗策略：无限制住院、积分或代金券系统、配给系统以及以患者表达的避免住院能力为中心的方法。
