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PSYCHIATRIC-TREATMENT IN A DELIMITED POPULATION - WITH PARTICULAR REFERENCE TO OUTPATIENTS

ACTA PSYCHIATRICA SCANDINAVICA 1976年第1期53卷 35-50页

作者： KASTRUP, M NAKANE, Y DUPONT, A BILLE, M INST PSYCHIAT DEMOG 8240 RISSKOV DENMARK RANDERS GEN HOSP PSYCHIAT DEPT 8900 RANDERS DENMARK

The present investigation analyzes the psychiatric service available to and utilized by a population in a geographically delimited area, namely the Randers area [Denmark] with a population of 108,928. During the period 1970-74, the average yearly rate of patients admitted to the 3 psychiatric institutions covering this area was per 1000: 7.9 males and 9.1 females. During 1970-71, 1.2 males and 1.8 females per 1000 were treated as outpatients in a psychiatric clinic affiliated to a psychiatric hospital, and a psychiatric outpatient clinic in a general hospital discharged 4.1 males and 7.7 females per 1000. Despite outpatient treatment the number of admissions increases slightly rather than decreases, and consequently, outpatient treatment cannot replace psychiatric admission.

关键词：丹麦住院医院精神病/统计学和数值数据精神障碍/流行病学精神障碍/治疗门诊部医院/统计学和数值数据精神病科医院/统计学和数值数据社会工作精神病青少年成年人老年人女(雌)性人类男(雄)性中年人

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A transition rate model for first admissions to psychiatric institutions

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STATISTICS IN MEDICINE 1999年第9期18卷 1111-1118页

作者： Oldehinkel, AJ Univ Groningen Dept Psychiat NL-9700 RB Groningen Netherlands

This paper describes the application of a parametric transition rate model, the generalized log-logistic model, to the duration of first admissions to psychiatric institutions. The final model included diagnosis, gender, age, living conditions and year of admission as covariates. Characteristics of the log-logistic model are described extensively. Parametric transition models offer challenging and promising possibilities to model duration of hospital stay. Copyright (C) 1999 John Wiley & Sons, Ltd.

关键词：医院精神病/统计学和数值数据住院时间/统计学和数值数据 Logistic模型精神障碍/流行病学荷兰/流行病学病人入院/统计学和数值数据青少年成年人老年人儿童儿童学龄前女(雌)性人类婴儿婴儿新生男(雄)性中年人

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Trends in special (high-security) hospitals 2: Residency and discharge episodes, 1986-1995

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BRITISH JOURNAL OF PSYCHIATRY 2000年第3期176卷 260-265页

作者： Butwell, M Jamieson, E Leese, M Taylor, P Inst Psychiat Dept Forens Psychiat London England

Background It has been argued-that many patients in special hospital beds do not need to be there. in the 1990s there were initiatives to discharge women and people with learning difficulties. Aims To test for trends in special hospital discharges and to examine annual resident cohorts. Method This study was from case registers and hospital records. The main measures were numbers and annual rates for referrals and beds offered: the Mental Health Act 1983 (MHA) classification of mental disorder;adjusted population rates by region;admission episodes;legal category of detention;admission source and type of offence. Results The median annual number of residents was 1859 (range 1697-1910), with an 8% fall for the period. This particularly affected people in mental impairment categories. Numbers were sustained in the male mental illness groups. Discharges, mainly to other institutions, increased. There was no overall change over the 10 years in length of stay for treatment, but successive admission cohorts from 1986 did show some reduction, even with solely remand order cases excluded. Conclusions Service planners need a longitudinal perspective on service use. Trends over 10 years to both fewer admissions and more discharges have reduced the special hospital population, but despite new treatments for schizophrenia, men under mental illness classification, as well as transfer from other secure settings. have gone against this trend.

关键词：医院精神病/统计学和数值数据医院精神病/发展趋势医院专科/统计学和数值数据医院专科/发展趋势住院时间病人入院/统计学和数值数据病人出院/统计学和数值数据病人转诊/统计学和数值数据性别分布女(雌)性人类男(雄)性

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Private sector coverage of people with dual diagnoses

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JOURNAL OF MENTAL HEALTH ADMINISTRATION 1996年第3期23卷 317-328页

作者： Garnick, DW Hendricks, AM Drainoni, ML Horgan, CM Comstock, C DEPT VET AFFAIRS FIELD PROGRAMCTR HLTH CARE QUAL OUTCOMES & ECON RESECON SECTBEDFORDENGLAND BOSTON UNIV MEDICAID WORKING GRPBOSTONMA 02215

In general, people with dual diagnoses account for a significant proportion of both the mental health and substance abuse populations. Most published information on dual diagnosis comes from research on selected treatment programs that are largely funded from public sources. This analysis uses private health insurance claims and eligibility files for 1989 to 1991 for three large firms to identify individuals with both substance abuse and mental health claims and to examine their characteristics, charges, and utilization. More than half of people with dual diagnoses incurred significant charges over three years in both mental health and substance abuse. These individuals with high mental health charges were more likely to be male than were patients with mental health claims alone;they were less likely to be male than were patients with claims for substance abuse and no mental health services. They were also significantly younger than were patients with substance abuse or mental health utilization only for two of the firms. The average charges for people with dual diagnoses were higher than those for patients with substance abuse or mental health claims only.

关键词：诊断双重(精神病学)/经济学保健福利计划雇员/统计学和数值数据保险索赔审核保险精神病/统计学和数值数据精神障碍/并发症精神障碍/经济学精神障碍/治疗精神卫生服务/经济学精神卫生服务/利用物质相关性障碍/并发症物质相关性障碍/经济学物质相关性障碍/治疗美国利用情况审核成年人女(雌)性人类男(雄)性

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Psychiatric hospitalization characteristics associated with insurance type

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ADMINISTRATION AND POLICY IN MENTAL HEALTH 1998年第4期25卷 437-448页

作者： Hendryx, MS DeRyan, J Washington State Univ Washington Inst Mental Illness Res & Training Spokane WA USA Washington State Univ Dept Psychol Spokane WA USA Washington State Univ Program Hlth Policy & Adm Spokane WA USA

This study examines the relationship among types of insurance and characteristics of inpatient psychiatric treatment. Data include 46,998 adult psychiatric or substance abuse cases from all 1991-1992 Washington State discharges from short-stay general hospitals. Large and significant differences among payers exist in treatment characteristics, controlling for diagnosis and patient age. For example, length of stay is longest among commercial and Medicare payers. Emergency admissions are more common among public payers, and elective admissions are more common among private payers, including HMOs, Results are discussed in light of policy and administration issues that will arise as financing for mental health services comes under greater capitation.

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Utilization of local jails and general hospitals by state psychiatric center patients

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JOURNAL OF BEHAVIORAL HEALTH SERVICES & RESEARCH 2000年第4期27卷 454-459页

作者： Banks, SM Stone, JL Pandiani, JA Cox, JF Morschauser, PC Briston Observ Bristol VT 05443 USA New York State Off Mental Hlth New York NY USA NYS Off Mental Hlth Bur Forens Sci New York NY USA

The idea that the deinstitutionalization of state psychiatric centers has resulted in increased utilization of general hospitals and correctional facilities by people with severe and persistent mental illness is widely held. This hypothesis of transinstitutionalization was tested by examining hospitalization and incarceration rates of people who had been or would be institutionalized in state psychiatric centers in 16 upstate New York counties. The results do not support the hypothesis of transinstitutionalization. Assumptions underlying the hypothesis are examined, potential explanations for the observed patterns are discussed, and areas for further research are suggested.

关键词：队列研究精神病人强制住院/发展趋势医院外治疗/发展趋势医院综合/统计学和数值数据医院综合/利用医院精神病/统计学和数值数据医院州立/统计学和数值数据收容入院/发展趋势纽约结果与过程评价(卫生保健) 监狱/统计学和数值数据监狱/利用回顾性研究女(雌)性人类男(雄)性

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THE EFFECT OF CHARACTERISTICS OF HUMAN-SERVICE WORKERS ON SUBSEQUENT MORALE AND TURNOVER

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ADMINISTRATION IN SOCIAL WORK 1995年第1期19卷 15-32页

作者： KOESKE, GF KIRK, SA UNIV CALIF LOS ANGELES SCH PUBL POLICY & SOCIAL RESRALPH & MARY CRUMP CHAIR SOCIAL WELFLOS ANGELESCA 90024

The authors examine the relationship of sociopsychological characteristics of human services workers to their subsequent morale and continuance on the job. Eighty-two intensive case managers (half of them social workers) who had caseloads of clients with severe mental disorders were invited to participate in a four-wave panel study. Explored are the relationships between 16 predictors (general background, prior work experience and training, and social psychological variables) and worker outcomes (beliefs, attitudes, perceptions, and turnover). The major finding was that better personal well-being at the time of hiring was the most consistent and significant predictor of lower burnout, higher job satisfaction, and generally higher worker morale at later points in time. Those from higher social class backgrounds and those with lower starting salaries were more likely to leave the job. Those workers with more experience had a tendency to perceive greater client improvement.

关键词：厌倦职业性/流行病学人种群/心理学职业满意士气纽约人员调整/统计学和数值数据问卷调查回归分析社会工作精神病/人力社会工作精神病/统计学和数值数据成年人人类男(雄)性

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Mental health care for Asian, black and white patients with non-affective psychoses: pathways to the psychiatric hospital, in-patient and after-care

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SOCIAL PSYCHIATRY AND PSYCHIATRIC EPIDEMIOLOGY 1999年第9期34卷 484-491页

作者： Commander, MJ Cochrane, R Sashidharan, SP Akilu, F Wildsmith, E No Bimingham Mental Hlth Trust Res & Dev Unit Erdington B23 6AL England Univ Birmingham Sch Psychol Edgbaston England

Background: This UK-based study compares the pathways to the psychiatric hospital and the provision of in-patient and after-care for Asian, black and white patients with non-affective psychoses. Method's: Two overlapping samples of 120 patients, 40 from each ethnic group, were drawn;one on admission and the other at discharge. In addition to socio-demographic data, details were obtained on the pathways to care and the in-patient episode. An assessment of needs and service provision was undertaken 3 months post-discharge. Patient satisfaction was ascertained at each stage. Results: Asian and especially black patients experienced more complex pathways and had higher levels of both involvement with the police and compulsory detention than their white counterparts. They were less likely to perceive themselves as having a psychiatric problem or as needing to go into hospital and expressed less satisfaction with the admission process. Black patients, as compared to Asian but especially white patients, were more often detained in hospital against their will, confined to the ward and treated within a secure environment. However. there were few differences in satisfaction with hospital care. Likewise, perceptions of unmet need? provision of after-care and satisfaction with services were similar across the ethnic groups. Conclusions: The implications of these findings are discussed. The potential of early intervention programmes and home treatment services to address the ethnic differentials identified in this study merit consideration.

关键词：非洲裔美国人/统计学和数值数据非洲大陆世系人群文化交叉比较人种群/统计学和数值数据欧洲大陆世系人群/统计学和数值数据大不列颠卫生服务需求住院/统计学和数值数据医院精神病/统计学和数值数据病人满意度精神病/人种学精神病/心理学抽样研究青少年成年人女(雌)性人类男(雄)性中年人

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Inventory of interpersonal problems: A three-dimensional balanced and scalable 48-item version

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JOURNAL OF PERSONALITY ASSESSMENT 2000年第2期74卷 296-310页

作者： Gude, T Moum, T Kaldestad, E Friis, S Univ Oslo Dept Behav Sci Med N-0317 Oslo Norway Modum Bads Nervesanatorium Dept Res Vikersund Norway Ulleval Hosp Dept Res & Educ Oslo Norway

Interpersonal relating has been a focus of attention in psychiatry for decodes. To address this domain, a self-rating scale, the inventory of interpersonal Problems (IIP: Horowitz. Rosenberg. Baer, Ureno, & Villasenor. 1988), was developed. Analysis of the psychometric properties of IIP presented in this article was performed by principal component analysis (PCA) for the purpose of obtaining subscales with a balanced, bipolar dimensionality. The model was validated by the resulting dimensions' ability to discriminate among different categories of personality disorders (PDs). The problem of a General Complaint factor affecting PCAs of questionnaires such as the IIP is discussed thoroughly. and ways of avoiding the problem are outlined, We present a three-dimensional structure of the ITP with both theoretically appealling and statistically robust dimensions of Assertiveness, Sociability, and Interpersonal Sensitivity based on 48 (out of 127) items. Balanced, additive indexes using the subset of 48 items appeared psychometrically sound by showing much lower correlations internally and less confounding from the General Complaint factor than extant indexes derived from the: IIP. External validity seemed to be bolstered by all subscales' discriminating significantly between different PDs versus no PDs. on both cluster and single diagnosis levels. Our analysis seemed to substantiate the reliability (scalability) of three dimensions of the IIP tapping different areas of the interpersonal relational field.

关键词：因素分析统计学医院精神病/统计学和数值数据住院病人/统计学和数值数据人际关系精神障碍/心理学挪威个性量表/标准心理测定学可重复性结果社会适应青少年成年人女(雌)性人类男(雄)性中年人

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Temporal regularities in physical control at a state psychiatric hospital

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ARCHIVES OF PSYCHIATRIC NURSING 2002年第2期16卷 80-85页

作者： Vittengl, JR Norfolk Reg Ctr Norfolk NE USA

Physical control (mechanical restraint and locked seclusion) of psychiatric patients has received increasing scrutiny, and better understanding of the timing of physical control would allow for more informed choices about its implementation. This study examined temporal regularities in the use of physical control at a general psychiatric hospital over a period of 8.6 years. As hypothesized, physical control was not randomly distributed through time but instead showed positive autocorrelation;yearly, weekly, and daily cycles;and higher frequency at patients' smoking, meal, and medication times. These results are discussed in the context of physical control research, theory, and policy. Copyright 2002, Elsevier Science (USA). All rights reserved.

关键词：医院精神病/统计学和数值数据医院州立/统计学和数值数据精神障碍/护理护理理论病人隔离/利用哲学护理学约束身体的/利用人类

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