RESUMO
To determine how a cohort of patients admitted to a mental health center in a single month used the center's clinical services over a year's time, an index of service utilization for each patient was developed. The weighted score took account of days of inpatient and day hospital care and minutes of outpatient time consumed. It was found that 15% of the cohort (48 patients of 330 admitted) used 70% of the total clinical services delivered to the cohort. Analyses of the data on patient characteristics as related to the index or score included the chi 2 test and multiple regression analysis. Not a single sociodemographic variable predicted high utilization of services. Only such clinical characteristics as severity of psychopathology as reflected in patients' diagnoses, suicidal behavior, and a history of prior inpatient treatment contributed to the prediction. The largest group of entrants had relatively brief encounters with the center, and the bulk of the services were actually delivered to a small, severely disturbed minority.
Assuntos
Serviços Comunitários de Saúde Mental/estatística & dados numéricos , Transtornos Mentais/terapia , Adolescente , Adulto , Assistência Ambulatorial/estatística & dados numéricos , Computadores , Connecticut , Hospital Dia/estatística & dados numéricos , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Tempo de Internação , Masculino , Transtornos Mentais/psicologia , Pessoa de Meia-IdadeRESUMO
The authors report their experience with a 12-item checklist used to score need for hospitalization. The checklist was filled in and scored by research assistants who reviewed the charts of 100 hospitalized and 50 nonhospitalized patients. A written opinion of a senior clinical consultant was available for hospitalized patients whose charts were rated low in need for hospitalization and for nonhospitalized patients whose charts were rated high. The checklist scores differentiated the two groups of patients. The authors can conclude that the checklist can be a valuable tool in a review process that culminates in review by an experienced clinician.
Assuntos
Hospitalização , Prontuários Médicos , Transtornos Mentais/diagnóstico , Connecticut , Hospitais Psiquiátricos , Humanos , Transtornos Mentais/terapia , Qualidade da Assistência à SaúdeRESUMO
We explored the association between patienthood and prevalence of symptomatology in the community. Base line data on prevalence were obtained through the use of a household survey. Characteristics of survey respondents (N equals 938) and patients admitted from the surveyed area to a Connecticut Mental Health Center during a 12-month period (N equals 808) were compared. High utilization of facilities was associated with the prevalence of symptoms in the community, particularly where defining characteristics were descriptors of disadvantaged social status. A second set of variables correlated with mental health center use but not with the prevalence of symptoms in the community. By and large, these characteristics describe a lack of social supports not necessarily related to social status. Finally, certain groups were underrepresented as patients even though comprising polulations-at-risk in terms of levels of symptom impairment in the community.
Assuntos
Serviços Comunitários de Saúde Mental/estatística & dados numéricos , Transtornos Mentais/epidemiologia , Adulto , Fatores Etários , Connecticut , Escolaridade , Emprego , Características da Família , Feminino , Humanos , Renda , Masculino , Pessoa de Meia-Idade , Pobreza , Grupos Raciais , Religião , Fatores Sexuais , Classe Social , Estatística como AssuntoRESUMO
Data were obtained from a mental health survey of a representative sample of 938 adults from a defined geographic area and 808 patients from the same area who were admitted to a community mental health center. Multivariate techniques were used to isolate factors that best predicted mental health center use. The existence of "patienthood" as a dimension of residence-related behavior was confirmed. Although psychological impairment was predictive of patienthood, other factors including age and familial and social disorganization also acted as mediators of patienthood. Indexes of social status, such as race and social class, did not emerge as major allocative mediators.
