护理模式的实施是否提高了监狱精神卫生服务的物有所值?

IF 1.3 4区 医学 Q3 CRIMINOLOGY & PENOLOGY
P. Rouse, K. Pillai, B. McKenna, A. Simpson, J. Cavney, J. Skipworth, R. Tapsell, D. Madell
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引用次数: 0

摘要

背景:关于监狱精神卫生服务中物有所值的适当措施的研究很少。目标:为新西兰五所监狱中对严重精神疾病患者的强化监狱护理模式制定和评估问责制框架。一个关键目标是确定在现有病例中缺失的这类疾病患者。方法:对一个通用的公共部门问责制框架进行了修改,利用事前/事后设计,围绕其有效性和经济性三个组成标准的效率提供了物有所值的衡量标准,从而可以衡量该监狱医疗保健模式的各个阶段之间的流量。措施被安排成围绕结果、产出、投入和成本的共同维度,在各个阶段有所不同。该框架中填充了从五个监狱收集的执行前后期间的数据。结果:在服务提供的所有五个领域,特别是在筛查、评估、干预和重返社会阶段,三项标准普遍有所改善。由于这三个标准是物有所值的主要组成部分,因此它们为改善这些监狱的精神卫生服务物有所值提供了证据。其他期望实现的操作变化是在分诊阶段护士与医生的比例增加了三倍,在治疗阶段医生与护士的比例略有增加。总体而言,这种护理模式的实施使案件数量从监狱总数的6.1%增加到7.3%,相当于案件数量增加了21%。结论:这一问责制框架证实了监狱严重精神疾病护理模式的物有所值,突出了表现良好的领域以及需要进一步发展的领域。该框架还提供了可作为持续监测中的关键绩效指标的措施。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Does the Implementation of a Model of Care Improve the Value for Money of Mental Health Services in Prisons?

Does the Implementation of a Model of Care Improve the Value for Money of Mental Health Services in Prisons?

Background

There is little research into appropriate measures of value for money in prison mental health services.

Aims

To develop and evaluate an accountability framework for an enhanced Prison Model of Care for people with serious mental illness in five New Zealand prisons. A key objective was to identify people with such illnesses who were missing from existing caseloads.

Methods

A generic public sector accountability framework was modified to provide measures of value for money around efficiency in its three component criteria of effectiveness and economy using a pre/post design, allowing measurement of flows between successive stages of this prison healthcare model. Measures were arranged into common dimensions around outcomes, outputs, inputs and costs, varied across the stages. The framework was populated with data collected from five prisons for the pre- and post-implementation periods.

Results

Improvements in the three criteria were generally obtained across all five areas of service delivery but especially in the screening, assessment, intervention and reintegration stages. Since these three criteria are major components of value for money, they provide evidence for improvement in value for money of the mental health services in these prisons. Other desired operational changes achieved were a threefold increase in the nurse to doctor ratio at the triage stage and slight increase in doctor to nurse ratio at the treatment stage. Overall, the implementation of this model of care achieved an increase in the size of caseload from 6.1% to 7.3% of the prison muster, equivalent to an increase in caseload of 21%.

Conclusions

This accountability framework confirmed the value for money of the Prison Model of Care for severe mental illness, highlighting areas of good performance as well as areas requiring further development. The framework also provides measures that can be used as key performance indicators in ongoing monitoring.

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来源期刊
CiteScore
1.60
自引率
0.00%
发文量
40
期刊介绍: Criminal Behaviour & Mental Health – CBMH – aims to publish original material on any aspect of the relationship between mental state and criminal behaviour. Thus, we are interested in mental mechanisms associated with offending, regardless of whether the individual concerned has a mental disorder or not. We are interested in factors that influence such relationships, and particularly welcome studies about pathways into and out of crime. These will include studies of normal and abnormal development, of mental disorder and how that may lead to offending for a subgroup of sufferers, together with information about factors which mediate such a relationship.
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