지역사회 거주 조현병 환자 대상 사례관리 서비스 중재 : 36개월 전향적 추적 연구
Efficacy of Case Management for the Community Dwelling Schizophrenia Patients : A 36-Month Prospective Follow-Up Study
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초록
Objectives This study was conducted to observe a longitudinal course of patients with schizo¬phrenia enrolled in a community mental health center (CMHC) in Seoul, Korea, and to evaluate the clinical efficacy of case management provided for them. Methods Study subjects, including 50 patients in a case-managed group, and 34 patients in the control group, were enrolled from a CMHC and followed up for 36 months. Annual length of hospitalization was compared between two groups by t-tests and time until hospitalization by Kaplan-Meier survival analysis. Results For the first year of observation, there was no significant difference in annual length of hospitalization between two groups (3.4 weeks vs. 2.9 weeks), but annual length of hospitaliza¬tion of the case-managed group became significantly shorter for the second (1.7 weeks vs. 7.2 weeks) and third year (1.4 weeks vs. 7.8 weeks). In Kaplan-Meier survival analysis, no difference in time until hospitalization was observed between two groups, but time until hospitalization more than 3 months was significantly shorter in the control group. Conclusion At least two years of case management was required to reduce the length of hos¬pitalization. Reduction in length of hospitalization was achieved by preventing long-term hospital¬ization.
Abstract
Objectives This study was conducted to observe a longitudinal course of patients with schizo¬phrenia enrolled in a community mental health center (CMHC) in Seoul, Korea, and to evaluate the clinical efficacy of case management provided for them. Methods Study subjects, including 50 patients in a case-managed group, and 34 patients in the control group, were enrolled from a CMHC and followed up for 36 months. Annual length of hospitalization was compared between two groups by t-tests and time until hospitalization by Kaplan-Meier survival analysis. Results For the first year of observation, there was no significant difference in annual length of hospitalization between two groups (3.4 weeks vs. 2.9 weeks), but annual length of hospitaliza¬tion of the case-managed group became significantly shorter for the second (1.7 weeks vs. 7.2 weeks) and third year (1.4 weeks vs. 7.8 weeks). In Kaplan-Meier survival analysis, no difference in time until hospitalization was observed between two groups, but time until hospitalization more than 3 months was significantly shorter in the control group. Conclusion At least two years of case management was required to reduce the length of hos¬pitalization. Reduction in length of hospitalization was achieved by preventing long-term hospital¬ization.
참고문헌 (38)
- Thornicroft G, "Textbook of community psychiatry" (2001), Oxford University Press
- Procedural guide to the mental health services for year 2014, "Ministry of health and welfare", Ministry of health and welfare, ~ (2014)
- II, "The chronic mental patient", pp.1987, Talbott JA
- Moore ST, "A social work practice model of case management: the case management grid", Soc Work, 35, pp.444~448 (1990)
- Lamb HR, "Therapist-case managers: more than brokers of services", Hosp Community Psychiatry, 31, pp.762~764 (1980)
- Stein LI, "Alternative to mental hospital treatment. I. Conceptual model, treatment program, and clinical evaluation", Arch Gen Psychiatry, 37, pp.392~397 (1980)
- Mueser KT, "Models of community care for severe mental illness: a review of research on case management", Schizophr Bull, 24, pp.37~74 (1998)
- Franklin JL, "An evaluation of case management", Am J Public Health, 77, pp.674~678 (1987)
- Ford R, "Providing the safety net: case management for people with a serious mental illness", J Ment Health, 4, pp.91~97 (1995)
- Macias C, "The role of case management within a community support system: partnership with psychosocial rehabilitation", Community Ment Health J, 30, pp.323~339 (1994)
- Marshall M, "Social services case-management for long-term mental disorders: a randomised controlled trial", Lancet, 345, pp.409~412 (1995)
- Marks IM, "Home-based versus hospital-based care for people with serious mental illness", Br J Psychiatry, 165, pp.179~194 (1994)
- Solomon P, "The working alliance and consumer case management", J Ment Health Adm, 22, pp.126~134 (1995)
- Marshall M, "Case management for people with severe mental disorders", Cochrane Database Syst Rev, (2), pp.CD000050~ (2000)
- Burns T, "Use of intensive case management to reduce time in hospital in people with severe mental illness: systematic review and meta-regression", BMJ, 335, pp.336~ (2007)
- Marshall M, "Assertive community treatment for people with severe mental disorders", Cochrane Database Syst Rev, (2), pp.CD001089~ (2000)
- Malone D, "Community mental health teams for people with severe mental illnesses and disordered personality", Schizophr Bull, 35, pp.13~14 (2009)
- 2002 report of community mental health commision, "Suh TW", Korea Institute for Health and Social Affairs, ~ (2002)
- Lee YM, "The effectiveness of psychosocial rehabilitation for chronic mentally ill patients of Suwon community mental health center", J Korean Assoc Soc Psychiatry, 8, pp.101~109 (2003)
- Lee KS, "The effect of the community-based mental health program on the improvement of daily living skills for the chronic mentally Ill", J Korean Acad Psychiatr Ment Health Nurs, 6, pp.141~152 (1997)
- Suh JH, "A study on the development and evaluation of vocational rehabilitation program for patients with schizophrenia", pp.1998
- Noh IY, "Comparative research of the medical cost, the quality of life, the family burden of the mentally ill before and after the community mental health service", J Korean Public Health Nurs, 15, pp.56~72 (2001)
- Lee JS, "A study on the effectiveness of case management for rehabilitation of the chronic mentally illness", J Korean Acad Psychiatr Ment Health Nurs, 11, pp.206~220 (2002)
- 정인원, "정신보건센터의 주간 및 직업재활 프로그램에 등록한 정신분열병 환자의 연령군간 특성", 신경정신의학, 43(1), pp.105~112 (2004), 대한신경정신의학회
- Kwon IJ, "A study on the effectiveness of community mental health services", pp.2007
- Overall JE, "The brief psychiatric ratingscale (BPRS)", Psychol Report, 10, pp.799~812 (1962)
- Overall JE, "The brief psychiatric ratingscale (BPRS):Recent developments in ascertainment and scaling", Psychopharmacology Bulletin, 24, pp.97~99 (1988)
- "WHO disability assessment schedule 2.0 (WHODAS 2.0)" (2014)[URL]
- 서수경, "우리나라 정신질환자의 의료이용 현황과 장기입원 관련 요인", 예방의학회지, 42(6), pp.416~423 (2009), 대한예방의학회
- Muijen M, "Home based care and standard hospital care for patients with severe mental illness: a randomised controlled trial", BMJ, 304, pp.749~754 (1992)
- Audini B, "Homebased versus out-patient", in-patient care for people with serious mental illness. Phase II of a controlled study, 1994, pp.165, 204~210
- Morse GA, "Experimental comparison of the effects of three treatment programs for homeless mentally ill people", Hosp Community Psychiatry, 43, pp.1005~1010 (1992)
- Lehman AF, "Rehabilitation for adults with severe mental illness and substance use disorders. A clinical trial", J Nerv Ment Dis, 181, pp.86~90 (1993)
- 이수정, "국내 지역사회 정신보건서비스 이용 정신장애인군과 재원환자군의 특성 비교 연구", 대한조현병학회지, 16(2), pp.51~61 (2013), 대한조현병학회
- Curtis JL, "Effect of case management on rehospitalization and utilization of ambulatory care services", Hosp Community Psychiatry, 43, pp.895~899 (1992)
- A 2011 report of the national mental health commission, "The National Mental Health Commission", The National Mental Health Commission, ~ (2011)
- Kim Y, "Factors affecting supply of mental health care services in Korea", J Korean Neuropsychiatr Assoc, 39, pp.860~869 (2000)
- The epidemiological survey of mental disorders in Korea, 2011, "Cho MJ", Seoul National University, ~ (2011)