Fulop N J, Koffman J, Carson S, Robinson A, Pashley D, Coleman K
Department of Public Health, Kensington & Chelsea and Westminster Health Authority, London.
J Public Health Med. 1996 Jun;18(2):207-16. doi: 10.1093/oxfordjournals.pubmed.a024481.
Concerns have been expressed, particularly in inner cities, about the growing pressure on acute psychiatric beds, evidenced by increased occupancy rates, difficulties in accessing beds, and increasing use of private beds by health authorities. This study investigated these concerns by conducting a census of psychiatric patients occupying acute beds. The proportion of patients who no longer required acute care and their needs for alternative provision were determined, together with bed occupancy rates.
A point prevalence survey of acute psychiatric patients in all National Health Service acute psychiatric units and seven private psychiatric units in North and South Thames regions was conducted on 15 June 1994. Sociodemographic, diagnosis and admission characteristics data were collected. Patients who no longer required acute care were identified and the alternative service provision required for these patients was determined. Bed occupancy rates were calculated.
A total of 3710 psychiatric patients (including those on leave) were ennumerated. More than one in five (23.2 per cent) were defined as inappropriately located. The main alternative services required for inappropriately located patients who could be discharged to the community were professional support in patient's home (71.5 per cent), and housing or more appropriate housing (61 per cent). For inappropriately located patients who could not be discharged into the community, the main alternative services required were group home (29.3 per cent) and in-patient rehabilitation (20.8 per cent). Bed occupancy rates were high on the day of the survey (95 per cent).
Best use is not being made of acute psychiatric beds in the Thames regions. A high proportion of patients occupying beds are those who no longer require acute care, but for whom alternative services are unavailable.
人们已经表达了担忧，尤其是在市中心，急性精神病床位面临的压力越来越大，入住率上升、获取床位困难以及卫生当局对私立床位的使用增加都证明了这一点。本研究通过对占用急性床位的精神病患者进行普查来调查这些担忧。确定了不再需要急性护理的患者比例及其对替代服务的需求，同时还统计了床位占用率。
1994年6月15日，对泰晤士河北部和南部地区所有国民保健服务急性精神病科以及七家私立精神病科的急性精神病患者进行了时点患病率调查。收集了社会人口统计学、诊断和入院特征数据。确定了不再需要急性护理的患者，并确定了这些患者所需的替代服务。计算了床位占用率。
共统计了3710名精神病患者（包括请假患者）。超过五分之一（23.2%）的患者被确定位置不当。对于可以出院到社区的位置不当患者，所需的主要替代服务是患者家中的专业支持（71.5%）以及住房或更合适的住房（61%）。对于无法出院到社区的位置不当患者，所需的主要替代服务是集体之家（29.3%）和住院康复（20.8%）。调查当天床位占用率很高（95%）。
泰晤士地区的急性精神病床位没有得到最佳利用。占用床位的患者中有很大一部分不再需要急性护理，但却没有可供他们使用的替代服务。
