On the Inside: A Narrative Review of Mental Health Inpatient Services

This paper describes and discusses the results of a narrativereview of inpatient mental health services in the UK. Four mainthemes emerge from the review: the growing pressure on inpatienthospital services; the negative experience of inpatient servicesreported by many service users; the problematic nature of hospitaldischarge; and possible alternatives to hospital admission.This review also suggests that a failure to recognize and acton what appears to be happening in hospitals could result ininpatient care once again being subject to the scrutiny andcriticism that cast a shadow over psychiatric services in the1960s and 1970s. To stop this happening, current governmentpolicy is right to focus attention back onto acute care throughnew guidance and by commissioning research. However, changesalso need to take place at a practice level so that front lineworkers are familiar with conditions in local acute servicesand can challenge unacceptable behaviour/services in supportof their service users. With current changes in the make-upof local mental health services and a greater emphasis on partnershipworking between health and social care, it may be that socialcare practitioners can do this not only from the outside, butincreasingly ‘on the inside’ (from within integratedhealth and social care organizations).     

Length of inpatient stays and associated factors among middle‐aged and older adults in Korea

Using a nationally representative sample of middle‐aged and older adults in Korea, this study examined the length of inpatient stays and associated factors. The pooled 2008–2012 data were obtained from the Korean Longitudinal Study of Aging, and study sample consisted of 7,805 individuals aged 50 and older. Guided by the Andersen's healthcare utilization model, latent growth curve modeling was conducted. Study results indicate that the average inpatient stay has slightly increased among middle‐aged and older adults in Korea. Furthermore, the severity of functional disability, the number of chronic health conditions, and the level of depressive symptoms were found to be key factors associated with the length of inpatient stays. In particular, respondents who received federal welfare benefits had longer stays than those who did not receive welfare benefits. Being employed and having private insurance were also found to be predictors of increasing length of inpatient stays. However, marital status was not associated with the length of inpatient stays. By understanding the pattern of inpatient stays and associated factors, policymakers should make an effort to develop innovative cost‐effective healthcare programs.     

The Status of Psychiatric Inpatient Group Therapy: Past,Present, and Future

This article examines the history, current conditions, and future possibilities of psychiatric inpatient group psychotherapy. Attention is directed toward exploring the purpose, structure, theoretical perspectives, and empirical research of inpatient group therapy. Trends in inpatient care are contextualized within a historical perspective and current politics of care. Future challenges to the viability of inpatient groups, including fiscal pressures, high patient acuity, shorter stays, and pressures for evidence-based practices, are considered.     

分级诊疗背景下住院患者流向及费用分析 ——以安徽省城乡居民为例

基于安徽省级医保信息平台获取36个县域城乡居民医保住院患者基础信息,统计描述住院患者的住院流向、住院费用及医保补偿基金分布等。2016—2019年,县域外住院人次占比为28.38%~30.79%;住院总费用、医保补偿基金和住院次均费用的年均增速分别为6.76%、11.34%和4.79%;县域外住院总费用、医保补偿基金占比最大且逐年增加;住院补偿比为53.78%~61.42%,县域外住院补偿比逐年增加。从城乡居民医保住院患者就诊流向来看,分级诊疗效果尚未显现,医保补偿基金流向县域外的趋势未得到有效控制。应通过加强紧密型医共体建设,提高基层服务能力等方面采取措施,支撑分级诊疗制度的落地。     

Integrating Solution-Focused Brief Therapy for Systemic Posttraumatic Stress Prevention in Paediatrics

Paediatric trauma can leave devastating effects on patients and their families if unattended. Medical family therapy (MedFT) is one approach to address the emotional and relational impact of paediatric trauma and prevent possible posttraumatic stress. The biopsychosocial model is widely practiced in MedFT, yet we argue that adding solution-focused conversations can further enhance practitioner effectiveness and increase client outcome. This article discusses and provides rationale for the use of solution-focused brief therapy (SFBT) through a biopsychosocial lens when treating paediatric intensive care unit (PICU) patients and their families. A fictionalised illustration is provided to guide family therapists in applying SFBT to the PICU population.     

海南省某三甲医院急性阑尾炎的住院费用 结构及影响因素分析

目的：通过对海南省某三甲医院急性阑尾炎患者的住院费用及影响因素的分析,找出住院费用结构中存在的问题及影响住院费用的主要因素,为控制医疗费用过度增长提供科学依据。方法：采用单因素和多因素分析方法对住院费用的影响因素进行分析。结果：住院费用结构中,检查化验等有形服务费用比重偏高,手术、护理、诊察等无形服务费用比重偏低;住院天数、是否手术、年龄、性别等四个因素对住院费用有显著影响。结论：加强医疗服务成本核算,建立科学合理的定价机制,严控有形服务的增长,加大对无形服务的补偿。     

福州市住院患者陪护服务供求状况研究

目的：了解住院患者陪护服务供求状况,以期为政府优化陪护服务管理提供依据。方法：采用自制调查表进行调查,EpiData录入数据并用SPSS22.0处理。结果：陪护服务供求矛盾主要体现在护工培训率低且培训效果有限、文化程度偏低且医学知识和护理技术欠缺难以满足患者需求,护工社会保障和监督管理制度亟待完善。结论：为解决住院患者陪护服务的供求矛盾,政府部门应积极完善护工的培训制度、保障制度和管理制度。     

Statistical Communiqué on Healthcare and Family Planning Development in China 2013

正In 2013,in accordance with the decisions and plans of the Party Central Committee and the State Council,health and family planning departments at all levels continuously deepened the reform of medical and health system;reinforced and improved the basic drug system and the new operation mechanism for grass-roots medical institutions;actively promoted reform of public hospitals;did well in prevention and control of major diseases and medical and health services;     

Effectiveness of the Coral Tree Family Service family inpatient unit: a longitudinal study exploring change in family functioning

Child mental health disorders represent a major burden to public health in Australia due to high prevalence rates, the widespread impact across domains, and the potential for difficulties to persist into adolescence and adulthood. Extensive evidence exists for the use of parent management training and cognitive behavioural therapy to treat difficulties experienced by children; however, a proportion of children do not benefit as expected from these treatments. The use of complementary therapeutic approaches and variations to the mode and intensity of existing intervention is warranted; family inpatient units represent a unique example of this. The aim of this study is to evaluate the effectiveness of a well-established Australian inpatient unit that admits the whole family, for children aged 12 years and younger referred with mental health, behavioural, or emotional difficulties. This study's longitudinal within-subject study design utilised routinely collected outcome data from the systemic clinical outcome and routine evaluation, 15 item (SCORE-15)—a valid and reliable measure of family functioning—from a sample of 980 participants attending the Family Residential Program. This study reported significant improvement in family functioning across all outcome variables between baseline and post-intervention, with no variables returning to pre-intervention levels at follow-up. Clinically significant changes in overall family functioning showed that 37% of participant scores moved from the clinical range at baseline to the nonclinical range post-intervention. This study represents the first empirical evaluation of the Family Residential Program, and the reported results provide compelling evidence for the program to effect improvement in family functioning for families with long-standing and severe difficulties. Poor rates of questionnaire completion following intervention frequent the literature base of family inpatient units, with low post-intervention (56%) and follow-up (12%) rates evident in this study. This study uniquely contributes to the growing evidence base of family inpatient units using rigorous evaluation methods.