灵活坚定的社区待遇与坚定的社区待遇或密集案例管理的结果
Martin Rotenberg1, Ling Zhuang1, Raquel Williams1
1Centre for Addiction and Mental Health, Toronto (all authors); Department of Psychiatry (Rotenberg, Raben, Naeem, Kurdyak, Foussias) and Department of Occupational Science & Occupational Therapy (Williams), University of Toronto, Toronto.
Psychiatric services (Washington, D.C.)
|February 21, 2025
概括
灵活的坚定社区治疗 (FACT) 与急性精神卫生服务中的坚定社区治疗 (ACT) 或密集病例管理 (ICM) 有类似的结果. 虽然随着FACT的出现,急诊室的访问量增加了,但住院患者的数量没有增加.
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
- 卫生服务管理卫生服务管理
背景情况:
- 灵活的坚定的社区治疗 (FACT) 越来越多地被采用,而没有强有力的证据证明其有效性.
- 自主社区治疗 (ACT) 和密集病例管理 (ICM) 是严重精神疾病的既定模式.
- 将FACT与ACT/ICM进行比较对于指导临床实践和资源分配至关重要.
研究的目的:
- 为了比较FACT与ACT或ICM在管理急性精神病医疗服务使用方面的有效性.
- 评估接受不同治疗方式的严重精神疾病的社区居民的结果.
主要方法:
- 一个准实验性的研究,利用倾向性得分与混因素的控制匹配.
- 在FACT的过渡和实施阶段,分析急性精神病学服务的使用情况 (急诊室访问,住院,住院).
- 在加拿大精神卫生医院接受FACT的队列和接受ACT或ICM的匹配队列之间的比较.
主要成果:
- 在FACT过渡期间,在急诊室访问,住院或住院日数方面没有发现显著差异.
- 在完全实施FACT期间,与ACT/ICM相比,FACT组的急诊室访问显著增加 (IRR=1.65).
- 在实施后,FACT和ACT/ICM组之间没有观察到入院或住院日数的显著差异.
结论:
- 事实证明,在急性住院服务使用方面,ACT/ICM的结果与ACT/ICM的结果相似.
- 在FACT用户中观察到急诊室访问的增加需要进一步调查.
- 这项研究提供了FACT在加拿大急性精神卫生服务利用中的初步证据.
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