Jones A, Norman I J
Department of Nursing Studies, City University, London, UK.
J Psychiatr Ment Health Nurs. 1998 Feb;5(1):21-31. doi: 10.1046/j.1365-2850.1998.00094.x.
Case management has become an established organizational approach to mental health care. However, a recent development of case management, known as 'managed care' has received only limited attention in the UK and this has been confined to acute medical or surgical hospital care. The potential of managed care as applied to mental health care is uncertain. This paper clarifies the nature of managed care and discusses its relevance to mental health care, in particular to the care of people suffering from schizophrenia. The high incidence and heavy resource demands of this user group makes these people an ideal focus for managed care. However, there are conceptual and practical problems hindering its development and implementation, including: the variability and unpredictability of the disease process of schizophrenia; challenges of outcome measurement; and problems relating to the current organization of mental health care.
病例管理已成为心理健康护理中一种既定的组织方法。然而，病例管理的一项最新发展，即“管理式医疗”，在英国受到的关注有限，且仅限于急性医疗或外科医院护理。管理式医疗应用于心理健康护理的潜力尚不确定。本文阐明了管理式医疗的本质，并讨论了其与心理健康护理的相关性，特别是与精神分裂症患者护理的相关性。这个用户群体的高发病率和对资源的巨大需求使其成为管理式医疗的理想关注点。然而，存在一些概念和实际问题阻碍其发展和实施，包括：精神分裂症疾病过程的变异性和不可预测性；结果测量的挑战；以及与当前心理健康护理组织相关的问题。
