Goldberg D, Jackson G, Gater R, Campbell M, Jennett N
Mental Illness Research Unit, University of Manchester.
Psychol Med. 1996 May;26(3):487-92. doi: 10.1017/s003329170003556x.
Thirty patients suffering from new episodes of depression or anxiety disorders seen by a hospital-based psychiatric service were matched for severity of illness with 30 patients seen by a community mental health team based upon primary care. These patients were drawn from a total of 108 such patients seen in the community and 57 seen by the hospital service. Clinical and social outcomes were similar in both groups, and neither was clearly superior in terms of quality of clinical information recorded. However, patients treated in the community were seen more quickly, had more continuity of care and were more satisfied with the service. Health services costs were less for those patients treated in the community, because patients were less likely to be admitted. With one atypical patient excluded, treatment by the community team is more cost effective. The greater number of patients seen by the primary-care-based service means that there is no overall cost saving to the NHS.
一家医院精神科服务机构接诊的30名新发抑郁症或焦虑症患者，与一家基于初级保健的社区心理健康团队接诊的30名患者在疾病严重程度上进行了匹配。这些患者分别来自社区中总共108名此类患者以及医院服务机构接诊的57名患者。两组的临床和社会结局相似，在记录的临床信息质量方面也没有哪一组明显更优。然而，在社区接受治疗的患者就诊更快，护理连续性更强，对服务也更满意。社区治疗的患者医疗服务成本更低，因为患者入院的可能性更小。排除一名非典型患者后，社区团队的治疗更具成本效益。基于初级保健的服务机构接诊的患者数量更多，这意味着对英国国家医疗服务体系（NHS）而言并没有总体成本节约。
