摘要
目的在考虑精神障碍住院治疗"急慢分治"需求的前提下,提出适合辽宁省的床位配置方案,为辽宁省精神卫生服务资源配置规划提供参考。方法通过国家统一编制资源调查问卷,调查辽宁省精神卫生床位资源的基本情况,结合文献复习获得目前使用住院服务的主要精神障碍的患病率和急慢性住院治疗的比例、住院日的数据,根据世界卫生组织(WHO)推荐的精神科床位配置计算公式,计算精神科床位配置方案。将实际资源情况与理论配置比较。结果全省实际开放床位数为26 976张(6.38张/万人),理论最低配置(满足可能有危害社会行为的精神病性障碍和双相障碍患者的急慢性住院治疗需要)为9 794张(床位密度2.32张/万人),其中急性床位3 864张,慢性床位5 930张;中等配置(在最低配置基础上,进一步满足有严重自杀倾向的重性抑郁障碍患者和有明显精神行为症状的老年痴呆患者的急性住院治疗需要)27 027张(床位密度6.39张/万人),其中急性床位21 096张,慢性床位5 930张;较高配置(在中等配置基础上,进一步满足可能致残的精神病性障碍和双相障碍患者的急、慢性住院治疗需要)44 281张(10.47张/万人),其中急性床位28 825张,慢性床位15 456张。结论辽宁省精神卫生床位资源丰富,总数及大多数地区已经达到中等床位资源水平,但辽宁省精神科床位未根据急慢性分治配置,严重精神障碍患者平均住院时间较长,可根据病情需要,划分急性、慢性住院治疗,缩短平均住院时长,整合资源,避免资源浪费。
ObjectiveBased on the principle of differentiating hospitalization needs of acute and chronic patients with mental disorder,a rational allocation scheme was proposed for developing the policy for beds resource allocation for mental health facilities.MethodsThe beds resources condition was surveyed by resources survey questionnaire uniformly made by the national agency.Other data were collected by literature review including the prevalence rates of the major mental disorders and the proportion of patients with mental disorders requiring inpatient treatment and their average hospitalization days.Then how many theoretical psychiatric beds should be allocated were calculated by World Health Organization computing formula and compared with the actual situation.ResultsLiaoning province have26976(6.38per10000population)psychiatric beds.The lowest level required own9749beds(2.32per10000population)for psychotic disorder and bipolar disorder patients who had high risk violence behavior,which comprising3864beds for acute admission and5930beds for chronic hospitalization.At the middle level,it included additonal beds for major depression patients with serious suicide risk,and dementia patients with serious psychotic symptoms,which in total27027beds(6.93per10000population)were required.The beds for acute hospitalization increased to21096.The high level,based on the middle level for meeting more requirementsfrom patients with psychotic disorder or bipolar disorder who had high risk of disability,the number of beds needed was44281beds(10.47per10000population)comprising28825for acute inpatient and15456beds for chronic hospitalization.ConclusionLiaoning have abundant mental health beds resources.Most cities own enough quantity psychiatric beds up to middle level allocation standard,but these beds were not divided according to the acute or chronic treatment principle.Besides,the average hospitalization duration was too long.Categorize types of beds and shorten hospitalization days,integrate resources and avoide waste according patients condition should be carried out in the future.
作者
任金涛
孟宪锋
王明涛
王金环
王哲
Ren Jintao;Meng Xianfeng;Wang Mingtao;Wang Jinhuan;Wang Zhe(Mental Health Center of Liaoning Province, Kaiyuan112300, China;The First Affiliated Hospital, China Medical University, Shenyang110001, China)
出处
《四川精神卫生》
2017年第5期446-450,共5页
Sichuan Mental Health
关键词
精神卫生
辽宁省
资源配置
床位
Mental health
Liaoning province
Resources allocation
Beds
