To what extent could acute general psychiatric day care reduce inpatient admissions?
Notice bibliographique
Résumé
Background: Percentage reduction of inpatient admissions by acute general psychiatric day care in individual facilities (i.e. feasibility rate of acute day care) seems to be an important parameter for service planning. Previously reported feasibility rates showed significant variation, however, and were based on eligibility criteria defined for randomized controlled trials. This paper aims to perform an in-depth exploration of the calculation method of these feasibility rates, to propose different calculation methods expanding research definitions to the reality of service provision, and to analyze the association between the availability of residential services in regional mental health service systems and these rates. Methods: Data from the randomization process of the European Day Hospital Evaluation (EDEN) study in which a total of 1117 patients were included in five sites provided the basis to calculate site-specific and overall rates of patients for whom this mode of treatment might be adequate. Sensitivity analyses were carried out by varying the selection of patients’ eligibility criteria and thus calculating different feasibility estimates. Data on the regional mental health care systems were collected by use of the European Service Mapping Schedule. Results: The use of four different calculation methods showed that site-specific feasibility rates of acute day care for general psychiatric patients varied from 13.8% to 25.7% up to 44.1% to 79.0%. Overall rates varied from 17.3% up to 67.7%, respectively. The high values were calculated under a scenario where the current acute day care model of care is enhanced to manage more complicated patients than currently treated under existing acute day care models. In three out of the four calculation methods higher rates were calculated for sites which demonstrated higher figures of residential services, and thus were less advanced in their process of deinstitutionalization. Conclusions: In order to determine the capacity of day hospitals as an alternative to acute psychiatric hospital care, mental health care planning must clearly decide on the eligibility criteria of patients to be treated in these facilities. Guided by such definitions, treatment concepts and professional qualifications of the staff in these facilities need to be adapted. The finding that less de-institutionalized regions may benefit most from a transition to acute day care as a means for promoting the transition to a community model of care for otherwise institutionalized patients must be assessed in more detail. Comprehensive research exploring the impact of all regional mental health service configuration characteristics on the concept of acute day care is needed.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,001 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».