Quality, costs, and effectiveness of services for older adults with mental disorders: a selective overview of recent advances in geriatric mental health services research
Quality, costs, and effectiveness of services for older adults with mental disorders: a selective overview of recent advances in geriatric mental health services research
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DOI：
10.1097/00001504-200207000-00011
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发表时间：
2002-07-01
影响因子：
6.9
通讯作者：
Bartels, SJ
中科院分区：
文献类型：
--
作者：
Bartels, SJ
审查的目的是，预计患有精神障碍的老年人人数将增加，这突出表明需要确定组织、提供和资助老年精神卫生服务的最佳模式。最近的工作提供了对关键领域的洞察，包括为患有精神障碍的老年人提供服务的质量和成本。本文简要概述了所选研究(发表于2001年)，这些研究涉及各种重要主题，包括护理质量、初级保健中的精神卫生治疗、治疗痴呆症的成本以及推进老年精神卫生服务研究的议程。最近的研究发现，患有精神障碍的老年人接受不充分或不适当护理的风险增加，包括较低质量的医疗保健、不适当的处方以及导致获得适当治疗的机会减少的成本控制策略。正在研究将心理健康和初级保健相结合的服务提供模式，以期增加获得机会、改善结果并有效管理医疗成本。然而，正式的有偿服务的成本只是故事的一部分。阿尔茨海默病的大部分费用与非正式家庭护理人员的费用有关，这突显了针对这一群体的有效支持服务的必要性。摘要最近的卫生服务研究表明，许多患有精神障碍的老年人的护理质量较差，与正式和非正式护理相关的巨额费用。描述了老年精神卫生服务研究的未来议程，包括需要解决受过培训的老年精神卫生服务研究人员和得到支持的研究的短缺问题。
Purpose of review The projected increase in the number of older individuals with mental disorders underscores the need to identify optimal models of organizing, delivering, and financing geriatric mental health services. Recent work has provided insight into key areas, including the quality and costs of services for older individuals with mental disorders. This paper provides a brief overview of selected studies (published in 2001) addressing a variety of important topics, including the quality of care, mental health treatment in primary care, the costs of treating dementia, and an agenda to advance geriatric mental health services research.Recent findings Older adults with mental disorders are at increased risk of receiving inadequate or inappropriate care, including a lower quality of healthcare, inappropriate prescriptions, and cost-containment strategies resulting in diminished access to adequate treatment. Models of service delivery that integrate mental health and primary care are being studied, with the expectation of increasing access, improving outcomes, and efficiently managing healthcare costs. However, the costs of formal, paid services are only part of the story. Most of the costs of Alzheimer's disease are associated with the cost of informal family caregivers, underscoring the need for effective support services aimed at this group.Summary Recent health services research documented a poor quality of care for many older individuals with mental disorders, and substantial costs associated with formal and informal care. A future agenda for geriatric mental health services research is described, including the need to address the shortfall in trained geriatric mental health services researchers and supported research.