A rapid-response outpatient model for reducing hospitalizadon rates among suicidal adolescents
A rapid-response outpatient model for reducing hospitalizadon rates among suicidal adolescents
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DOI：
10.1176/appi.ps.53.12.1574
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发表时间：
2002-12-01
影响因子：
3.8
通讯作者：
Platt, R
中科院分区：
文献类型：
--
作者：
Greenfield, B;Larson, C;Platt, R
目的：作者研究了自杀青少年的临床结局，这些青少年在快速反应门诊模式下接受治疗，在这种模式下，通常需要等待10天才能开始门诊治疗，住院治疗是唯一立即可用的选择。研究方法：共有286名12至17岁的自杀青少年来到儿科医院急诊科，被分配到接受快速反应门诊随访（实验组）或对照组。在基线时获得人口统计学和临床数据，并在2个月和6个月时获得结局数据。结果：两组患者的人口统计学和临床特征在基线时相似。实验组和对照组的住院率在基线时分别为10%和40%，两个月随访时分别为17%和41%，六个月随访时分别为IS %和43%，相当于实验组六个月时住院的相对风险为0.41。在随访期间，没有观察到自杀倾向水平或整体功能的变化存在组间差异，并且没有患者在6个月内死亡。结论：接受快速反应门诊随访的自杀青少年的住院率低于未接受快速反应门诊随访的自杀青少年。两组在功能水平和自杀倾向水平方面取得了相似的提高，这表明自杀青少年可以在快速反应门诊模式中得到治疗，从而避免住院治疗。
Objective: The authors studied the clinical outcomes of suicidal adolescents who were treated within a rapid-response outpatient model in a setting in which a ten-day wait was usually required before outpatient treatment could be started, leaving hospitalization as the only immediately available alternative. Methods: A total of 286 suicidal adolescents aged 12 to 17 years who came to the emergency department of a pediatric hospital were assigned to receive rapid-response outpatient follow-up (the experimental group) or to a control group. Demographic and clinical data were obtained at baseline, and outcomes data were obtained at two and six months. Results: The demographic and clinical, characteristics of the two groups were similar at baseline. Hospitalization rates in the experimental and control groups, respectively, were 10 percent and 40 percent at baseline, 17 percent and 41 percent at two-month follow-up, and IS percent and 43 percent at six-month follow-up, corresponding to a relative risk of hospitalization of .41 in the experimental group at six months. No between-group differences were observed in changes in levels of suicidality or in overall functioning over the follow-up period, and none of the patients had died at six months. Conclusions: Suicidal adolescents who received rapid-response outpatient follow-up had a lower hospitalization rate than those who did not. The two groups achieved similar increases in levels of functioning and decrease in levels of suicidality, suggesting that suicidal adolescents can be treated within a rapid-response outpatient model and thus avoid hospitalization.