Goethe J W, Dornelas E A, Fischer E H
Institute of Living, Hartford, CT 06106, USA.
Compr Psychiatry. 1996 Mar-Apr;37(2):115-21. doi: 10.1016/s0010-440x(96)90571-4.
We report the initial results from a prospective study designed to assess patients' functional outcome and level of service utilization following psychiatric hospitalization. All patients admitted between March 31, 1993 and April 1, 1994 were interviewed at admission and discharge, and 350 consenting patients were reassessed 3 months postdischarge. Subgroups were created using cluster analysis (measures of outcome were rehospitalization, self-rated productivity and functioning, and satisfaction with living situation and employment/daily activities at the 3-month follow-up study), and these clusters were then validated using other variables. Four distinct outcome categories were identified. Cluster I contained patients with the greatest functional impairment and the highest rate of rehospitalization (28%). Cluster IV patients reported superior functioning and satisfaction and the lowest rate of rehospitalization (8%). Clusters II and III had intermediate outcomes, the first characterized by greater satisfaction with living situation, and the other by higher ratings for functioning and productivity. Outcome data are important to providers for program evaluation and patient care; if replicated in other samples, the four outcome categories reported may be useful for national mental health care policy and planning.
我们报告了一项前瞻性研究的初步结果,该研究旨在评估精神病住院治疗后患者的功能结局和服务利用水平。对1993年3月31日至1994年4月1日期间入院的所有患者在入院时和出院时进行了访谈,并对350名同意参与的患者在出院后3个月进行了重新评估。使用聚类分析创建了亚组(结局指标为再住院率、自评生产力和功能,以及在3个月随访研究中对生活状况和就业/日常活动的满意度),然后使用其他变量对这些聚类进行验证。确定了四个不同的结局类别。第一组包含功能损害最大且再住院率最高(28%)的患者。第四组患者报告功能和满意度较高,再住院率最低(8%)。第二组和第三组的结局处于中间水平,第一组的特点是对生活状况的满意度较高,另一组的特点是功能和生产力评分较高。结局数据对提供者进行项目评估和患者护理很重要;如果在其他样本中得到重复,所报告的四个结局类别可能对国家精神卫生保健政策和规划有用。