荷兰强制护理法:对紧急非自愿入院、治疗和住院时间可能产生的影响

IF 1.3 4区 医学 Q1 LAW
S. Gemsa , E.O. Noorthoorn , P. Lepping , H.A. de Haan , G.J.M. Hutschemaekers
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引用次数: 0

摘要

目的《特别录取法》(1994年)于2020年被《荷兰义务医疗法》(2018年)所取代。之前的法律主要侧重于住院期间的非自愿治疗,而《强制医疗法》(2018年)旨在减少非自愿治疗,并允许在不可避免的情况下在住院和门诊环境中进行非自愿治疗。本研究的主要目的是评估观察到的立法变化对住院时间和非自愿护理选择的影响,重点是在急性入院期间进行药物治疗和隔离。方法数据从荷兰东部的一家大型精神健康信托基金收集。我们比较了2016年和2017年以及2020年和2021年的卫生保健监测数据。这些数据涵盖了非自愿治疗和住院和门诊条件下的短期法律条款。结果研究年份非自愿住院患者数与短期非自愿急诊病例数具有完全可比性。与2016 - 2017年相比,2020-2021年非自愿用药的使用频率更高;然而,隔离的使用要少得多。在短期紧急条目内开始的入院总时间从法律变更前的96天显著减少到法律变更后的71天(效应值= 0.225,p = 0.012)。短期紧急许可的非自愿住院天数保持不变。住院病人非自愿用药几乎翻了一番。非自愿门诊以药物治疗为主,主要在出院期间和出院后进行,很少在入院前或入院后进行。结论法律变更后,强制医疗的使用频率和患者数量相似。在这项研究中,药物使用的增加与住院时间的显著减少有关。非自愿用药在门诊的使用频率低于住院,尽管这可能是避免非自愿急诊入院的一种手段。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The Dutch Compulsory Care Act: Possible effects on emergency involuntary admissions, treatment, and length of stay

Purpose

The Special admissions Act (1994) was replaced in 2020 by the Dutch Compulsory Care Act (2018). Whereas the former law focused mainly on involuntary treatment during an inpatient admission, the Compulsory Care Act (2018) aims to reduce involuntary care and allows involuntary care in in- and outpatient settings if unavoidable. The main aim of this study is to assess the observed impact of the change in legislation on admission duration and the use of involuntary care options with a focus on medication and seclusion during acute admissions.

Methods

Data were collected from a large Mental Health Trust in the east of the Netherlands. We compared health care monitoring data from the years 2016 and 2017 and 2020 and 2021. The data cover involuntary treatment and the short-term law articles warranting these in both inpatient and outpatient settings.

Results

In the years studied the number of patients treated involuntarily and the number of short-term involuntary emergency articles were fully comparable. Involuntary medication was used more often in 2020–2021 than in 2016–17; however, seclusion was used much less. The total duration of admissions started within a short-term emergency article decreased significantly from 96 days before the change in the law to 71 days after the law change (Effect size = 0.225, p = 0.012). Days of involuntary inpatient stay within a short-term emergency authorization remained the same. Inpatient involuntary medication almost doubled. Involuntary outpatient care by means of medication was mainly used during and after discharge, seldom before or without admission.

Conclusions

After the change in the law, compulsory care was used with similar frequency and for a similar number of patients. In this study an increase in the use of medication was associated with a significant reduction in the length of inpatient admissions. Involuntary medication was used less frequently in an outpatient than in an inpatient setting, despite being possible as a means to avoid involuntary emergency admissions.
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来源期刊
CiteScore
4.70
自引率
8.70%
发文量
54
审稿时长
41 days
期刊介绍: The International Journal of Law and Psychiatry is intended to provide a multi-disciplinary forum for the exchange of ideas and information among professionals concerned with the interface of law and psychiatry. There is a growing awareness of the need for exploring the fundamental goals of both the legal and psychiatric systems and the social implications of their interaction. The journal seeks to enhance understanding and cooperation in the field through the varied approaches represented, not only by law and psychiatry, but also by the social sciences and related disciplines.
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