Florio E R, Rockwood T H, Hendryx M S, Jensen J E, Raschko R, Dyck D G
Washington Institute for Mental Illness Research & Training, Washington State University, Spokane, USA.
J Case Manag. 1996 Fall;5(3):106-14.
This article describes the client characteristics and services needs of community-dwelling older adults found through a unique case-finding model developed at the Spokane Mental health Center. The model trains the employees of community businesses and corporations who work with the public to serve as community gatekeepers by identifying and referring community-dwelling older adults who may be in need of aging and/or mental health services. These community case-finders perform a gatekeeping function for older adults that is similar to that performed by schools and the workplace for younger persons. Information was collected on 777 individuals aged 60 and older referred over an 18-month period (January 1, 1994, to June 30, 1995) to the Spokane Mental Health Clinical Case Management Program in Spokane, Washington, which provides aging and mental health services to older adults residing in the county. Findings indicate that 40% of clients referred were found by community-based gatekeepers. Clients referred by gatekeepers were more frequently socially isolated, economically disadvantaged, and less likely to have a physician. Gatekeeper clients were also more likely to be women and to be younger than others referred to the agency. Gatekeeper clients were receiving fewer services at referral and were identified as needing more services at intake. Gatekeepers find a distinct population of community-dwelling older adults who are not found by more traditional referral sources. The need to integrate this model within a comprehensive clinical case management system is discussed.
本文描述了通过斯波坎心理健康中心开发的独特病例发现模型所确定的社区居住老年人的客户特征和服务需求。该模型培训社区商业和企业中与公众打交道的员工，让他们充当社区守门人，识别并转介可能需要老龄和/或心理健康服务的社区居住老年人。这些社区病例发现者为老年人履行的守门人职能，类似于学校和工作场所为年轻人履行的职能。在18个月期间（1994年1月1日至1995年6月30日），收集了777名60岁及以上被转介至华盛顿州斯波坎心理健康临床病例管理项目的个人信息，该项目为居住在该县的老年人提供老龄和心理健康服务。研究结果表明，40%的被转介客户是由社区守门人发现的。由守门人转介的客户更常出现社会孤立、经济弱势的情况，而且看医生的可能性更小。守门人转介的客户也更有可能是女性，且比转介至该机构的其他客户更年轻。守门人转介的客户在被转介时接受的服务较少，在 intake时被确定需要更多服务。守门人发现了一个独特的社区居住老年人群体，而这些人是更传统的转介来源所未能发现的。本文还讨论了将该模型纳入综合临床病例管理系统的必要性。 （注：intake在医学领域可能有多种含义，这里根据上下文猜测是指接收客户信息时的某个环节，具体准确含义需结合更多背景信息确定，暂保留英文未翻译）
