PDF(Pubmed)
Abstract：
BACKGROUND: Long-term mental health (MH) policies in Finland aimed at investing in community care and promoting reforms have led to a reduction in the number of psychiatric hospital beds. However, most resources are still allocated to hospital and community residential services due to various social, economic and political factors. Despite previous research focussing on the number and cost of these services, no study has evaluated the emerging patterns of use, their technical performance and the relationship with the workforce structure.
OBJECTIVE: The purpose of this study was to observe the patterns of use and their technical performance (efficiency) of the main types of care of MH services in the Helsinki-Uusimaa region (Finland), and to analyse the potential relationship between technical performance and the corresponding workforce structure.
METHODS: The sample included acute hospital residential care, non-hospital residential care and outpatient care services. The analysis was conducted using regression analysis, Monte Carlo simulation, fuzzy inference and data envelopment analysis.
RESULTS: The analysis showed a statistically significant linear relationship between the number of service users and the length of stay, number of beds in non-hospital residential care and number of contacts in outpatient care services. The three service types displayed a similar pattern of technical performance, with high relative technical efficiency on average and a low probability of being efficient. The most efficient acute hospital and outpatient care services integrated multidisciplinary teams, while psychiatrists and nurses characterized non-hospital residential care.
CONCLUSIONS: The results indicated that the number of resources and utilization variables were linearly related to the number of users and that the relative technical efficiency of the services was similar across all types. This suggests homogenous MH management with small variations based on workforce allocation. Therefore, the distribution of workforce capacity should be considered in the development of effective policies and interventions in the southern Finnish MH system.
OBJECTIVE: The purpose of this study was to observe the patterns of use and their technical performance (efficiency) of the main types of care of MH services in the Helsinki-Uusimaa region (Finland), and to analyse the potential relationship between technical performance and the corresponding workforce structure.
METHODS: The sample included acute hospital residential care, non-hospital residential care and outpatient care services. The analysis was conducted using regression analysis, Monte Carlo simulation, fuzzy inference and data envelopment analysis.
RESULTS: The analysis showed a statistically significant linear relationship between the number of service users and the length of stay, number of beds in non-hospital residential care and number of contacts in outpatient care services. The three service types displayed a similar pattern of technical performance, with high relative technical efficiency on average and a low probability of being efficient. The most efficient acute hospital and outpatient care services integrated multidisciplinary teams, while psychiatrists and nurses characterized non-hospital residential care.
CONCLUSIONS: The results indicated that the number of resources and utilization variables were linearly related to the number of users and that the relative technical efficiency of the services was similar across all types. This suggests homogenous MH management with small variations based on workforce allocation. Therefore, the distribution of workforce capacity should be considered in the development of effective policies and interventions in the southern Finnish MH system.
摘要：
背景：芬兰旨在投资于社区护理和促进改革的长期精神卫生（MH）政策已导致精神病医院病床数量的减少。然而,由于各种社会因素，大部分资源仍分配给医院和社区居民服务，经济和政治因素。尽管以前的研究集中在这些服务的数量和成本上，没有研究评估新兴的使用模式，他们的技术性能以及与劳动力结构的关系。
目的：本研究的目的是观察赫尔辛基-乌西马地区（芬兰）MH服务的主要护理类型的使用模式及其技术性能（效率），并分析技术绩效与相应的劳动力结构之间的潜在关系。
方法：样本包括急性住院护理，非住院护理和门诊护理服务。分析采用回归分析，蒙特卡罗模拟，模糊推理和数据包络分析。
结果：分析表明，服务用户数量与住院时间之间存在统计上显着的线性关系，非医院住院护理的床位数量和门诊护理服务的接触者数量。这三种服务类型显示了类似的技术性能模式，平均相对技术效率高，效率低。最有效率的急症医院及门诊护理服务综合多学科小组,而精神科医生和护士的特点是非医院住宿护理。
结论：结果表明，资源数量和利用率变量与用户数量呈线性关系，并且所有类型的服务的相对技术效率相似。这表明基于劳动力分配的MH管理具有较小的差异。因此,在制定芬兰南部MH系统的有效政策和干预措施时，应考虑劳动力能力的分布。
目的：本研究的目的是观察赫尔辛基-乌西马地区（芬兰）MH服务的主要护理类型的使用模式及其技术性能（效率），并分析技术绩效与相应的劳动力结构之间的潜在关系。
方法：样本包括急性住院护理，非住院护理和门诊护理服务。分析采用回归分析，蒙特卡罗模拟，模糊推理和数据包络分析。
结果：分析表明，服务用户数量与住院时间之间存在统计上显着的线性关系，非医院住院护理的床位数量和门诊护理服务的接触者数量。这三种服务类型显示了类似的技术性能模式，平均相对技术效率高，效率低。最有效率的急症医院及门诊护理服务综合多学科小组,而精神科医生和护士的特点是非医院住宿护理。
结论：结果表明，资源数量和利用率变量与用户数量呈线性关系，并且所有类型的服务的相对技术效率相似。这表明基于劳动力分配的MH管理具有较小的差异。因此,在制定芬兰南部MH系统的有效政策和干预措施时，应考虑劳动力能力的分布。
