Short time effect of a self-referral to inpatient treatment for patients with severe mental disorders: a randomized controlled trial

被引：16

作者：

Moljord, Inger Elise Opheim ^{[1
,2
,3
]}

Helland-Hansen, Kristel Antine ^{[1
]}

Salvesen, Oyvind ^{[4
]}

Olso, Turid Moller ^{[5
]}

Gudde, Camilla Buch ^{[6
,7
]}

Rise, Marit By ^{[4
]}

Steinsbekk, Aslak ^{[4
]}

Eriksen, Lasse ^{[1
,2
]}

机构：

[1] St Olavs Univ Hosp, Div Psychiat, Nidaros Community Mental Hlth Ctr, Ostmarkveien 21,Post Box 1893, N-7440 Trondheim, Norway

[2] Norwegian Univ Sci & Technol, Dept Neurosci, Fac Med, Trondheim, Norway

[3] St Olavs Univ Hosp, Div Psychiat, Dept Res & Dev, Trondheim, Norway

[4] Norwegian Univ Sci & Technol, Dept Publ Hlth & Gen Practice, Fac Med, Trondheim, Norway

[5] Norwegian Univ Sci & Technol Social Res AS, Norwegian Resource Ctr Community Mental Hlth, Trondheim, Norway

[6] St Olavs Univ Hosp, Forens Dept Broset, Ctr Res & Educ Forens Psychiat, Trondheim, Norway

[7] Norwegian Univ Sci & Technol, Fac Social Sci & Technol Management, Dept Social Work & Hlth Sci, Trondheim, Norway

来源：

BMC HEALTH SERVICES RESEARCH | 2016年 / 16卷

关键词：

Self-referral to inpatient treatment; Patient controlled admission; Psychosis; User participation; Patient activation; SERVICE USERS EXPERIENCES; ACTIVATION MEASURE; PSYCHOMETRIC PROPERTIES; RECOVERY; SCHIZOPHRENIA; CARE; IMPLEMENTATION; GUIDANCE; MODEL;

D O I：

10.1186/s12913-016-1712-z

中图分类号：

R19 [保健组织与事业（卫生事业管理）];

学科分类号：

摘要：

Background: Service user participation is a central principle in mental healthcare, and the opportunity to self-refer to inpatient treatment is used to increase service user involvement and activation. The aim of this study was to investigate the short-term effect of a self-referral system in an inpatient rehabilitation unit at a community mental health center on patient activation and recovery in individuals with severe mental disorders. Methods: A randomized controlled study including 53 patients (41 % females, mean age 40 years). Twenty-six patients in the intervention group were given a contract for self-referral to inpatient treatment, limited to maximum 5 days and a quarantine time of 14 days between each stay. The control group (27 participants) received treatment as usual, and was offered the intervention after 1 year. The Patient Activation Measure was the primary outcome and secondary outcome was the Recovery Assessment Scale. Mixed models were used to assess group differences. Results: During the 4 months period, 15 (58 %) of 26 participants in the intervention group used the contract of self-referral to inpatient treatment. The intervention group had more admissions than the control group but both groups had a similar total use of inpatient days and out-patient consultations. The self-referral to inpatient treatment counted for 11 % of all inpatient days for the intervention group. There were no significant differences in the outcome between the groups on patient activation (estimated mean difference 2.7, 95 % confidence interval = -5.5 to 10.8, p = 0.52) or recovery (estimated mean difference 0.01, 95 % confidence interval = -0.3 to 0.3, p = 0.92). Conclusions: Giving persons with severe mental disorders the possibility to self-refer to inpatient treatment did not change their level of patient activation and recovery after 4 months and did not lead to increased use of health services. The cost-effectiveness and long-term effect of self-referral to inpatient treatment should be investigated further.

引用

页码：1 / 10

页数：10

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