Clinical and Cost-Effectiveness of Acute and Subacute Residential Mental Health Services: A Systematic Review
Clinical and Cost-Effectiveness of Acute and Subacute Residential Mental Health Services: A Systematic Review
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DOI：
10.1176/appi.ps.201200427
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发表时间：
2013-11-01
影响因子：
3.8
通讯作者：
Rickwood, Debra
中科院分区：
文献类型：
--
作者：
Thomas, Kerry A.;Rickwood, Debra
目的：认识到住院患者和社区护理之间的服务差距，已经开发了一系列精神卫生服务，为住院以外的精神疾病患者提供治疗和支持。急性和亚急性住宿服务为经历急性精神疾病发作的个人提供护理，并提供过渡性服务，帮助人们重新融入社区。本文对评估这些替代服务的有效性的研究进行了系统的回顾。方法：通过检索MEDLINE、SqucINFO、CINAHL和Cochrane进行系统的文献综述，没有具体说明年份，以确定评估急性或亚急性住宅治疗的临床有效性、用户满意度或成本效益的研究。结果数据从定量研究中提取，与服务满意度相关的主题从定性研究中提取。结果：共有26项研究对急性或亚急性住宿服务的有效性进行了评估。大多数对急性住院病房的研究表明，临床改善与住院病房相同，再住院率相似，并且具有成本效益。用户满意度普遍较高的客户的急性住宅单位。只有三项研究检查了亚急性病房，这个数字不足以评估这些服务的有效性。结论：急性住院精神卫生服务提供的治疗结果与住院病房相同，用户报告的满意度很高。急症住院服务为住院服务提供了一种具有成本效益的替代方案。需要进一步研究，以确定将从这些替代服务中受益最大的客户群体。
Objective: In recognition of a service gap between hospital inpatient and community-based care, a range of mental health services have been developed to provide treatment and support for people with mental illness outside the inpatient setting. Acute and subacute residential services provide care for individuals experiencing episodes of acute mental illness and provide transitional services to assist people in their reintegration into the community. This article provides a systematic review of studies evaluating the effectiveness of these alternative services. Methods: A systematic review of the literature was conducted by searching MEDLINE, PsycINFO, CINAHL, and Cochrane with no years specified to identify studies that have evaluated the clinical effectiveness, user satisfaction, or cost-effectiveness of acute or subacute residential treatments. Outcome data were extracted from quantitative studies, and themes relevant to service satisfaction were extracted from qualitative studies. Results: A total of 26 studies were identified that evaluated the effectiveness of acute or subacute residential services. Most studies of acute residential units demonstrated clinical improvements equal to those of inpatient units and similar readmission rates, as well as cost benefits. User satisfaction was generally higher for clients of acute residential units. Only three studies examined subacute units, a number not sufficient to evaluate the effectiveness of these services. Conclusions: Acute residential mental health services offer treatment outcomes equivalent to those of inpatient units, with users reporting high satisfaction. Acute residential services offer a cost-effective alternative to inpatient services. Further research is needed to determine client groups that will benefit most from these alternative services.