为边界性人格障碍患者设计社区服务,以减少住院治疗
Simon Graham1, Kathryn Gardner1, Ivan Sebalo1
1Spring House Psychotherapy and Personality Disorder Service (Graham) and Ashworth Research Centre, Ashworth High Secure Hospital (Sebalo), Mersey Care NHS Foundation Trust, Liverpool, United Kingdom; School of Psychology and Humanities (Gardner, Sebalo, Thornton) and Applied Health Research Hub (Benedetto, Clegg), University of Central Lancashire, Preston, United Kingdom.
为边界性人格障碍患者建立本地病例管理团队和危机服务,减少了住院和地区外治疗. 这种干预措施改善了患者的治疗结果,并节省了住院费用.
科学领域:
- 精神病学是一个精神病学.
- 心理健康服务研究 心理健康服务研究
背景情况:
- 以前的边缘性人格障碍 (BPD) 干预研究主要集中在心理治疗上.
- 患有严重失调的患者往往难以获得传统的办公室心理治疗.
研究的目的:
- 评估当地病例管理团队和综合日间治疗/危机服务对BPD患者的区域外治疗 (OAT) 和住院治疗的影响.
- 评估这种综合服务模式的成本效益.
主要方法:
- 在英国利物浦研究了42名BPD患者的队列.
- 医院入院和OAT数据在干预后12,24和36个月与基线进行了比较.
- 该干预涉及将所有患者从OATs遣返回国,并防止新的OAT转诊.
主要成果:
- 观察到住院病人的数量显著减少:在12个月内49%,在24个月内64%,在36个月后74%.
- 所有接受区域外治疗的患者都成功地被遣返回国.
- 虽然住院费用下降,但其他一些社区服务的利用率和成本有所增加.
结论:
- 一个集成的本地病例管理和危机服务可以有效地减少边界人格障碍患者的住院和地区外治疗.
- 这种服务模式表明,在住院护理中,可以节省大量成本.
- 需要仔细监控其他服务的使用情况,以管理整体系统成本.
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