Bickman L, Summerfelt W T, Noser K
Center for Mental Health Policy, Vanderbilt Institute of Public Policy Studies, Vanderbilt University, Nashville, TN 37212, USA.
Psychiatr Serv. 1997 Dec;48(12):1543-8. doi: 10.1176/ps.48.12.1543.
This study compared six-month functional and symptom outcomes of children and adolescents with serious emotional disturbance who received services in an exemplary system of care with outcomes of children who received traditional care. The system of care offers a comprehensive and coordinated network of mental health and other necessary services.
The study used a randomized longitudinal experimental design. Baseline data on symptoms, functioning, and family characteristics were collected from 350 families selected from among those who sought services for children from community agencies in Stark County, Ohio. The families were randomly assigned to either the experimental group, which received services from the system of care, or the control group, which received usual care in the community. Six-month outcome measures of children's symptoms and functioning were compared for the two groups.
Although access to care and the amount of care received increased under the system of care, no differences in clinical or functional outcomes were found between the group served in the system of care and the group who received usual care.
The effects of systems of care are primarily limited to system-level outcomes such as access to and cost of care and do not appear to affect clinical outcomes such as functioning and symptoms.
本研究比较了在一个模范式照护体系中接受服务的患有严重情绪障碍的儿童和青少年在六个月时的功能和症状结果，以及接受传统照护的儿童的结果。该照护体系提供了一个全面且协调的心理健康及其他必要服务网络。
本研究采用随机纵向实验设计。从俄亥俄州斯塔克县社区机构为儿童寻求服务的家庭中选取350个家庭，收集有关症状、功能和家庭特征的基线数据。这些家庭被随机分配到实验组（接受照护体系的服务）或对照组（在社区接受常规照护）。比较两组儿童在六个月时的症状和功能结果测量值。
尽管在照护体系下获得照护的机会和接受的照护量有所增加，但在照护体系中接受服务的组与接受常规照护的组之间，在临床或功能结果方面未发现差异。
照护体系的效果主要限于系统层面的结果，如获得照护的机会和照护成本，似乎并未影响功能和症状等临床结果。
