Scott J E, Dixon L B
Dept. of Psychiatry, University of Maryland School of Medicine, Baltimore 21201, USA.
Schizophr Bull. 1995;21(4):657-68. doi: 10.1093/schbul/21.4.657.
This review examines the impact of assertive community treatment (ACT) and case management models on the use of inpatient hospitalization and other community mental health services, costs, and other clinical and social outcomes. ACT programs have been found to reduce hospitalization and increase use of community mental health services at an equivalent or reduced cost. Greater fidelity to the ACT model produced better outcomes. The impact of case management models is less consistent, but intensive case management programs also have been found to reduce hospitalization. We discuss limitations in past research and recommend future directions.
本综述探讨了积极社区治疗(ACT)和个案管理模式对住院治疗的使用、其他社区心理健康服务、成本以及其他临床和社会结果的影响。研究发现,ACT项目能够减少住院治疗,并以相同或更低的成本增加社区心理健康服务的使用。对ACT模式的更高忠诚度产生了更好的效果。个案管理模式的影响不太一致,但强化个案管理项目也被发现能够减少住院治疗。我们讨论了过去研究中的局限性,并推荐了未来的研究方向。