Raskin R, Novacek J, Bahlinger D, Firth L
Tulsa Institute of Behavioral Sciences, OK 74120, USA.
Psychiatr Serv. 1996 Nov;47(11):1227-32. doi: 10.1176/ps.47.11.1227.
This study proposes a model with five criteria for evaluating the effectiveness of intensive outpatient behavioral health care programs and applies this model to a brief partial hospital-crisis stabilization program. The five criteria are client selection, program attendance, service utilization and focus of treatment, client improvement, and cost-effectiveness.
The program evaluation model was tested with a sample of 285 adults with severe mental illness who were admitted for or were receiving outpatient treatment at a state-funded community mental health center. Evaluation data included pre- and postprogram ratings by clinical staff of clients' symptoms, level of functioning, and treatment readiness; current and retrospective reports of clients' symptoms based on interviews with clients; and clients' service and financial records. Clients and clinicians also provided data about the problems addressed during treatment sessions.
Program dropouts used significant facility resources before dropping out. Clients who participated in the partial hospital-crisis stabilization program showed reduced symptoms, improved daily functioning, and improved treatment readiness. Clients who showed more improvement cost less to treat.
The evaluation model produced the information necessary for demonstrating program effectiveness. The results support the belief that clinical effectiveness and cost-effectiveness are positively related.
本研究提出了一个具有五项标准的模型,用于评估强化门诊行为健康护理项目的有效性,并将该模型应用于一个简短的部分住院危机稳定项目。这五项标准是客户选择、项目参与度、服务利用和治疗重点、客户改善情况以及成本效益。
该项目评估模型在285名患有严重精神疾病的成年人样本中进行了测试,这些成年人在一家由国家资助的社区心理健康中心接受住院或门诊治疗。评估数据包括临床工作人员在项目前后对客户症状、功能水平和治疗准备情况的评分;基于对客户访谈的客户症状的当前和回顾性报告;以及客户的服务和财务记录。客户和临床医生还提供了有关治疗期间所解决问题的数据。
项目辍学者在辍学前使用了大量的设施资源。参与部分住院危机稳定项目的客户症状减轻,日常功能改善,治疗准备情况提高。改善更明显的客户治疗成本更低。
评估模型产生了证明项目有效性所需的信息。结果支持了临床有效性和成本效益呈正相关的观点。