Unidad de Hospitalización Domiciliaria del Hospital del Mar. Equipo de atención psiquiátrica domiciliaria en el área de Barcelona / Psychiatric Home Hospitalization Unit of the Hospital del Mar. A crisis resolution and home treatment team in Barcelona

Introducción: A pesar del desarrollo de la hospitalización domiciliaria en España durante los últimos años, es llamativa la escasez de literatura. El siguiente estudio pretende exponer los datos obtenidos por la Unidad de Hospitalización a Domicilio de Psiquiatría del Hospital del Mar (HADMar). HADMar es un programa de hospitalización domiciliaria creado hace 2años, que recibe pacientes procedentes de servicios comunitarios y hospitalarios con un seguimiento limitado en el tiempo. Al alta, el paciente es derivado a la unidad de referencia ambulatoria apropiada para cada caso. Material y métodos: Se seleccionó a todos los pacientes visitados desde 2015 hasta la actualidad. Se llevó a cabo un estudio descriptivo que define las características sociodemográficas de la muestra. Las variables clínicas estudiadas fueron la gravedad de los síntomas, el riesgo de suicidio y los cambios en la funcionalidad. Resultados: Un total de 135 pacientes fueron incluidos en la muestra. La edad media de los pacientes fue de 44,6 años y no hubo diferencias entre ambos sexos. De ellos, 26 pacientes tenían un historial de intentos autolíticos y el 11,1% vivían solos. El 51,1% fueron diagnosticados de un trastorno psicótico. La puntuación media en la escala GEP en la variable gravedad de los síntomas psiquiátricos fue 2,39 y el riesgo medio de suicidio 0,49. La puntuación de EEAG al alta era mayor que al ingreso. Conclusiones: Los resultados obtenidos en nuestro estudio son consistentes con resultados reportados en estudios previos. Los equipos de hospitalización domiciliaria han demostrado ser una alternativa a la hospitalización tradicional. Sin embargo, se necesitan más estudios que apoyen estos resultados

Introduction: Although home hospitalization has begun to develop widely in recent years there is a notable lack of studies. The following study includes data from the Psychiatric Home Hospitalization Unit of the Hospital del Mar (HADMar). This program has been running for 2years and takes place in a socio-demographically depressed area in Barcelona. It receives patients from community and hospital services. Monitoring is limited in time and at discharge patient are referred to the ambulatory unit. Material and methods: All patients visited from 2015 to the present time were selected. A total of 135 patients were included in the sample. A qualitative descriptive study was carried out in order to define the socio-demographic characteristics. The severity of symptoms, suicidal risk and changes in the functionality were considered as clinical outcomes. Results: The mean age of patients was 44.6 years and there were no gender differences. A total of 26 patients had a history of suicidal attempts and 11.1% lived alone; 51.1% were diagnosed with a psychotic disorder. The mean GEP score for the severity of the psychiatric symptoms was 2.39 and the mean risk of suicide was 0.49. There is an increase in the EEAG score from admission to discharge, which means an improvement in the functionality of patients. Conclusions: The results obtained in our study are consistent with previous results. Home crisis intervention teams have proved to be an alternative to traditional hospitalization. However, more studies are needed to support these results

Psychiatric Home Hospitalization Unit of the Hospital del Mar. A crisis resolution and home treatment team in Barcelona. / Unidad de Hospitalización Domiciliaria del Hospital del Mar. Equipo de atención psiquiátrica domiciliaria en el área de Barcelona.

INTRODUCTION: Although home hospitalization has begun to develop widely in recent years there is a notable lack of studies. The following study includes data from the Psychiatric Home Hospitalization Unit of the Hospital del Mar (HADMar). This program has been running for 2years and takes place in a socio-demographically depressed area in Barcelona. It receives patients from community and hospital services. Monitoring is limited in time and at discharge patient are referred to the ambulatory unit. MATERIAL AND METHODS: All patients visited from 2015 to the present time were selected. A total of 135 patients were included in the sample. A qualitative descriptive study was carried out in order to define the socio-demographic characteristics. The severity of symptoms, suicidal risk and changes in the functionality were considered as clinical outcomes. RESULTS: The mean age of patients was 44.6 years and there were no gender differences. A total of 26 patients had a history of suicidal attempts and 11.1% lived alone; 51.1% were diagnosed with a psychotic disorder. The mean GEP score for the severity of the psychiatric symptoms was 2.39 and the mean risk of suicide was 0.49. There is an increase in the EEAG score from admission to discharge, which means an improvement in the functionality of patients. CONCLUSIONS: The results obtained in our study are consistent with previous results. Home crisis intervention teams have proved to be an alternative to traditional hospitalization. However, more studies are needed to support these results.

Las urgencias psiquiátricas: oportunidades para la adherencia terapéutica. El programa E.M.S.E. Barcelona / Multidisciplinary Team of Specialized support (EMSE): A mobile outreach Project for psychiatric emergency home visits in the city of Barcelona

Introducción: se presenta la implantación de un nuevo dispositivo asistencias, el Equipo Multidisciplinar de Soporte Especializado (EMSE). Este es resultado de un programa de soporte y atención a las urgencias psiquiátricas extrahospitalarias en la ciudad de Barcelona (061). Se describen las características del programa, las fases de desarrollo y se realiza una evaluación. Métodos: se analiza la fase 2, se estudian los pacientes valorados en el domicilio en el periodo del 1 de enero del 2004 al 31 de diciembre de 2004. Las alertas son 196, de las cuales se generan 109 casos que serán tributarios de intervención domiciliaria. Resultados: el 55,5% son trastornos mentales graves desvinculados de la red, y el 22,6% son trastornos mentales vinculados pero que han sido atendidos hace más de cuatro semanas. La historia de trastorno psiquiátrico se caracteriza por tener un tiempo medio sin recibir tratamiento de 40 meses (DS ± 59,2 meses). El delirio, conductas de aislamiento y la agitación-agresividad son las razones de consulta principales. Los diagnósticos se agrupan en el espectro del trastorno esquizofrénico. Las recomendaciones-disposiciones de la consulta, el 48,4% se resuelven en ingresos involuntarios y el 22,6% finalizan en el Centro de Salud Mental. En la evaluación a los cuatro meses, se obtiene un 80% de vinculación en los casos gestionados por EMSE. Conclusiones: la utilidad del programa se constata al comprobar la adherencia al tratamiento. Además este dispositivo puede ser predictor y observatorio de detección de necesidades(AU)

Introduction: our group has set up a program for psychiatric emergency home interventions. It is composed of a multidisciplinary mobile outreach team (EMSE) that attends to spychicatic emergency units called for on the local emergency number (061). Objective: to describe the program, the phses of development and a preliminary evaluation. Methods: a descriptive analysis of home interventions from January 2004 to December 2004. During 2004 teher were 196 calls, of which 109 required home intervention. Results: 55,5% were severe mental disorders that were not being treated at the time. The most frequent motives for consultation were delusions, behavior associated with isolation and agitation-aggression. The diagnoses were classified in the spectrum of schizophrenic disorders. The results from intervention indicate that 48,4% are admitted involuntarily and 22,6% are referred to mental health community centres. The evaluation is positive and results in a 80% follow-up and adherence to treatment by patients. Conclusions: This program is proving both satisfactory and necessary. The adherence to treatment reflects the success of the interventions. The program will also be useful in predicting and detecting further needs(AU)