Meisler N, Santos A B, Rowland M D, Smith S, Molloy M, Tyson S
Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston 29425, USA.
Adm Policy Ment Health. 1997 Nov;25(2):141-52. doi: 10.1023/a:1022234904523.
Even among comprehensive local public mental health systems, there remain large gaps in continuity of care following discharge from inpatient settings. The authors describe a modification of the assertive community treatment (ACT) program model that links inpatients to ongoing community-based care, and provide preliminary evidence of its effectiveness as a component in a rationally organized comprehensive system of care. Given the recent trend toward managed Medicaid arrangements, there will be increased pressure to reduce clients' length of stay in ACT programs. State mental health authorities are cautioned to resist allowing managed care contractors to radically change the conditions under which ACT programs operate until there is greater evidence of the effectiveness of alternative approaches.
即使在全面的地方公共心理健康系统中，住院患者出院后的持续护理仍存在很大差距。作者描述了一种对积极社区治疗（ACT）项目模式的改进，该模式将住院患者与持续的社区护理联系起来，并提供了其作为合理组织的综合护理系统一部分有效性的初步证据。鉴于近期医疗补助管理安排的趋势，减少客户在ACT项目中的停留时间的压力将会增加。在有更多证据证明替代方法的有效性之前，州心理健康当局应谨慎行事，抵制让管理式医疗承包商从根本上改变ACT项目的运作条件。
