- Klíčová slova
- komunita,
- MeSH
- charakteristiky bydlení MeSH
- deinstitucionalizace * dějiny metody organizace a řízení statistika a číselné údaje MeSH
- lidé MeSH
- management péče o pacienta dějiny MeSH
- péče o pacienta dějiny metody statistika a číselné údaje MeSH
- postižení * MeSH
- zdravotní politika MeSH
- Check Tag
- lidé MeSH
- Geografické názvy
- Norsko MeSH
BACKGROUND: Reports linking the deinstitutionalisation of psychiatric care with homelessness and imprisonment have been published widely. AIMS: To identify cohort studies that followed up or traced back long-term psychiatric hospital residents who had been discharged as a consequence of deinstitutionalisation. METHOD: A broad search strategy was used and 9435 titles and abstracts were screened, 416 full articles reviewed and 171 articles from cohort studies of deinstitutionalised patients were examined in detail. RESULTS: Twenty-three studies of unique populations assessed homelessness and imprisonment among patients discharged from long-term care. Homelessness and imprisonment occurred sporadically; in the majority of studies no single case of homelessness or imprisonment was reported. CONCLUSIONS: Our results contradict the findings of ecological studies which indicated a strong correlation between the decreasing number of psychiatric beds and an increasing number of people with mental health problems who were homeless or in prison.
BACKGROUND: The Quality Indicator for Rehabilitative Care (QuIRC) is an international, standardised quality tool for the evaluation of mental health facilities that provide longer term care. Completed by the service manager, it comprises 145 items that assess seven domains of care: living environment; treatments and interventions; therapeutic environment; self-management and autonomy; social interface; human rights; and recovery based practice. We used the QuIRC to investigate associations between characteristics of longer term mental health facilities across Europe and the quality of care they delivered to service patients. METHODS: QuIRC assessments were completed for 213 longer term mental health units in ten countries that were at various stages of deinstitutionalisation of their mental health services. Associations between QuIRC domain scores and unit descriptive variables were explored using simple and multiple linear regression that took into account clustering at the unit and country level. RESULTS: We found wide variation in QuIRC domain scores between individual units, but across countries, fewer than a quarter scored below 50 % on any domains. The quality of care was higher in units that were smaller, of mixed sex, that had a defined expected maximum length of stay and in which not all patients were severely disabled. CONCLUSIONS: This is the first time longer term mental health units across a number of European countries have been compared using a standardised measure. Further use of the QuIRC will allow greater understanding of the quality of care in these units across Europe and provide an opportunity to monitor pan-European quality standards of care for this vulnerable patient group.
- MeSH
- deinstitucionalizace statistika a číselné údaje MeSH
- dlouhodobá péče * metody psychologie normy MeSH
- duševní poruchy * epidemiologie rehabilitace MeSH
- duševní zdraví normy MeSH
- lidé MeSH
- péče o sebe * metody statistika a číselné údaje MeSH
- průřezové studie MeSH
- služby péče o duševní zdraví organizace a řízení MeSH
- ukazatele kvality zdravotní péče normy MeSH
- ústavy pro duševně nemocné * klasifikace normy statistika a číselné údaje MeSH
- zajištění kvality zdravotní péče metody MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Evropa MeSH
