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Multi-disciplinary Psychiatric Case Management Model in Hong Kong: Service Coverage and Risk Stratification

机译:香港多学科精神病案例管理模式:服务覆盖范围和风险分层

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Introduction: Community mental health services in Hong Kong follow a multi-disciplinary case management model. We investigated whether at-risk patients received higher intensity care and whether risk stratification concorded between personalised care programmes and integrated community centres of mental wellness. Methods: Records of all patients in North Lantau and Mongkok districts who received case management services (from personalised care programmes and/or integrated community centres of mental wellness) between 1 April 2014 and 30 June 2015 were reviewed. Patients’ levels of risk, demographic data, and clinical characteristics were analysed. Results: Identified at-risk patients received high-intensity care from personalised care programmes and integrated community centres of mental wellness. Case management was coordinated between the Hospital Authority and non-government organisations. However, risk stratification did not correlate with assessment rating scores of psychopathology or psychosocial functioning. Assessment rating scales appear unsuitable to provide any optimal cut-off scores for risk stratification. Conclusions: Risk stratification should be a structured clinical judgement based on comprehensive and accurate information of protective and risk factors, rather than relying on cut-off scores of assessment rating scales.
机译:简介:香港的社区心理健康服务遵循多学科案例管理模式。我们调查了风险患者是否接受了更高的强度护理,以及个性化护理计划和综合社区健康中心之间是否符合风险分层。方法:2014年4月1日至2015年6月30日期间,北大屿山和蒙科地区所有患者的患者记录北方大屿山及蒙科区,从2015年6月30日之间进行了案例管理服务。分析了患者风险,人口统计数据和临床特征的水平。结果:确定的风险患者从个性化护理计划和综合社区健康中心接受高强度护理。案例管理是在医院管理局和非政府组织之间协调。然而,风险分层与精神病理学或心理社会功能的评估评估分数无关。评估评级尺度显得不适合提供风险分层的任何最佳截止分数。结论:风险分层应是基于保护和危险因素的全面和准确信息的结构化临床判断,而不是依赖于评估评级规模的截止分数。

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