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首页> 外文期刊>The British journal of psychiatry : >Exposure to case management: relationships to patient characteristics and outcome
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Exposure to case management: relationships to patient characteristics and outcome

机译：接触病例管理：与患者特征和结果的关系

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Background Trials in community psychiatry must balance rigour with generalisability. The UK700 trial failed to find a significant effect on hospitalisation, but its sample population contained significant heterogeneity of exposure to case management in the two groups. Aims To test whether patients successfully exposed to a minimum of 12 months' intensive case management over the 2-year follow-up period achieved reduced hospitalisation. Method Of 679 participants with hospitalisation data, 84 were identified as having 12 months' exposure owing to prolonged hospitalisation, imprisonment or a combination of the two. These patients were excluded and outcomes tested for the remaining 595 patients. Results Overall reduced case-load size did not reduce hospitalisation or treatment costs over 2 years despite elimination of outliers. Age, previous hospitalisation and source of recruitment to the study all correlated with outcome. Conclusions Case-load reduction is not in itself enough to reduce the need for hospital care in psychosis. Baseline patient characteristics (in particular length of previous hospitalisation and recruitment from in-patient care) have a significant influence and should be allowed for in power calculations. Identifying the optimal clinical profile for patients likely to benefit from intensive case management remains a pressing need for further studies.
机译：背景社区精神病学的试验必须在严谨性和可推广性之间取得平衡。 UK700试验未能对住院产生重大影响，但其样本人群在两组病例管理中均存在显着异质性。目的为了测试在两年的随访期内患者是否成功成功接受了至少12个月的强化病例管理，减少了住院治疗。方法在679名有住院数据的参与者中，有84名被确定为由于长期住院，监禁或两者结合而暴露时间少于12个月。这些患者被排除在外，其余595名患者接受了结局测试。结果尽管消除了异常值，但总体而言，减少病例数并没有减少2年的住院或治疗费用。年龄，先前的住院治疗和研究的招募来源均与结果相关。结论减少病例量本身不足以减少精神病患者的住院治疗需求。基线患者特征（特别是先前住院的时间和从住院治疗中重新招募）具有重大影响，应该在功效计算中考虑到这一点。确定可能从强化病例管理中受益的患者的最佳临床概况仍然是进一步研究的迫切需求。

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