Mayfield D G, Fowler D R
Dis Nerv Syst. 1977 May;38(5):320-3.
The effects of social class and delivery system on admission and behavioral variables, diagnosis, treatment, and length of hospitalization were studied by comparing patients admitted over a one-year period to the psychiatric services of a public and a private general hospital, staffed by the same Department of Psychiatry. Patients were of similar age and sex and were matched by social class. Crisis-precipitated admissions and affective-disorder diagnoses varied with social class irrespective of treatment facility. Patients diagnosed as schizophrenic were more common in the upper classes at the private facility and the lower classes at the public facility. Somatic treatments and length of hospitalization also varied according to social class as well as delivery system. The results of this study imply that economic differences between public and private delivery systems operate to select patients for admission and affect expeditiousness of treatment, perhaps to the detriment of patients in both systems.
通过比较在一年时间内入住由同一精神科部门配备人员的一家公立医院和一家私立综合医院精神科服务的患者，研究了社会阶层和医疗服务体系对入院情况、行为变量、诊断、治疗及住院时长的影响。患者年龄和性别相仿，并按社会阶层进行了匹配。无论治疗机构如何，因危机而入院以及情感障碍诊断均因社会阶层而异。被诊断为精神分裂症的患者在私立机构的上层社会阶层中更为常见，而在公立医院的下层社会阶层中更为常见。躯体治疗和住院时长也因社会阶层以及医疗服务体系而异。这项研究的结果表明，公立和私立医疗服务体系之间的经济差异在选择入院患者方面发挥作用，并影响治疗的及时性，这可能对两个体系中的患者都不利。
