International journal of partial hospitalization最新文献

Procedures for augmenting subjective, anecdotal self-reports by outpatients with reliable, objective symptomatic data are discussed. The collection of rate data by patients in nonclinical settings is advocated as a source of relevant information for physicians and other health-care professionals. Methodological and training concerns are discussed. A case study illustrates the procedure.

The young chronically psychiatrically disabled adult (YAC) is a challenging new clinical subgroup for whom specialized treatment approaches are being developed. This paper examines the role of the partial hospital in the treatment of YACs and asserts that it should play a central role in such treatment. Specific YAC partial-hospital program characteristics are explicated.

Day hospitals serve an important function in the rehabilitation of psychiatric patients. Community aftercare services are especially important to patients in this type of care. In order to determine the aftercare needs of day-hospital psychiatric patients in the Ottawa-Carleton region, a survey was conducted. A semistructured interview with a standardized questionnaire was administered by trained interviewers. Questions were asked regarding service use, problems encountered, and patient satisfaction. Information on housing, educational-vocational, financial, social-recreational, and medical services was gathered. The application of the study results to the planning of community psychiatric aftercare services for day-hospital patients is discussed.

Proponents of day treatment for children and adolescents assert that this mode of intervention is a viable alternative to hospitalization based on both treatment and cost effectiveness. Preliminary studies on treatment effectiveness are beginning to appear in the literature. This paper focuses on the relative cost difference of treating children and adolescents in a day-treatment program vs three inpatient-hospital settings. The study finds that the populations in the two settings are similar with regard to demographic and diagnostic characteristics and that day treatment is significantly less costly on a daily basis. A conservative conclusion, based on the findings reported, is that over the course of treatment partial hospitalization is equal or less costly than hospitalization. The authors conclude that further research exploring both treatment efficacy and cost effectiveness is in order to define what role day treatment should serve in the continuum of mental health-care services for children and adults.

Psychiatric partial hospitalization (day treatment) has long been recognized as a cost-effective alternative to inpatient psychiatric treatment. However, this modality has been underutilized in the past. Present circumstances in medicine and psychiatry warrant the reconsideration of this treatment modality. This paper presents criteria for admission and utilization of psychiatric partial-hospitalization services. This is an effort to present a prototype for utilization of this service which can be used not only to educate referral sources but to provide a framework for review of admission and lengths of stay for third-party payers and other interested parties who, at the present time, are not familiar with this type of service. Clinical examples were provided.

The nuts and bolts of establishing a data base for a children's day psychiatric treatment center are described and discussed. Special attention is given to both human and technical factors by providing examples drawn from the experience of setting one up and from clinical data. Illustrations are also included that outline the concepts presented.

The effects of program structure on patient attendance rates within a day-hospital program were studied. It has been recognized that regular attendance at partial-hospitalization programs is necessary to facilitate improvement in patient skill deficits. In this study, three different program structures were offered in a 40-person day program. Significant differences in attendance rates were achieved.

In order to assess the development and current status of partial hospitalization in The Netherlands, a survey was conducted among the 85 Dutch institutions active in this field. The response rate to a carefully formulated questionnaire was 100%. The 85 institutions included in the study offered 1914 places at which 2995 patients per week received treatment. This kind of facility in The Netherlands has apparently developed differently from those in the United States and Great Britain. The Dutch version of the partial-hospitalization program (php) has two main functions: it serves (1) as an alternative to ambulant treatment and (2) as a continuation, or extension, of inpatient treatment. The functions of day care and php as an alternative to inpatient treatment have not yet been fully developed. This study also includes data on facilities, staffing, contraindications and selection, patient population and diagnoses, therapeutic activities, and costs.

A survey of 82 programs operating nationally is used to assess the present status of child and adolescent day-treatment services. Overwhelming variability in the responses leads the authors to suggest criteria for standards and definition. Survey results are presented for programming issues, patients, staff, clinical issues, funding, and research, followed by specific recommendations in each area. The authors conclude that without substantial changes toward standardization, child and adolescent day-treatment programs will continue to struggle in the highly competitive mental health-care market.

A team of male psychiatric patients drawn from two community mental-health day-treatment centers competed in a community-based softball league. Treatment objectives were twofold: therapeutic recreation and participation in a community activity apart from a traditional psychiatric setting. Points of success, while anecdotal, seem to suggest avenues through which further efforts toward community integration may be achieved.